Ulcerative Colitis: Hemorrhagic ulcer disease, as well as Crohn’s disease, is a chronic intestinal inflammatory disease (IBD) of the colon and rectum. If Crohn’s disease can occur anywhere in the digestive tract and reach the tissues at depth, colitis Ulcer is a superficial involvement of the mucosa, which begins at the rectum to ascend into the colon.
There are four forms of ulcerative colitis, depending on the extent of the disease:
In Canada, it is estimated that almost two out of every 1,000 people (men, women, and children) have ulcerative colitis. In another country, France, the incidence of UC has decreased to 3.5 / 100,000 while it increases for Crohn’s disease. In Europe, it is 1.7 to 20.3 / 100 000 and is more frequent in northern Europe than in the south (Norway / Portugal gradient)
The disease is diagnosed, especially in people aged 30 to 40 years, but it can occur at any age. Men and women affected in almost the same proportions, but not at the same age. This could be related to the smoker or former smoker status. There is a female predominance for Crohn’s disease, a less pronounced masculine predominance.
There is a genetic predisposition to ulcerative colitis. Hemorrhagic ulcerative colitis (HCV) is due to a dysregulation of the immune system that attacks the cells of its own organism. Scientists believe that the inflammation of the colorectal mucosa is due to an excessive immune reaction of the body against viruses or bacteria present in the intestine. According to the most probable hypothesis, this autoimmune reaction would be directed against the “harmless” bacteria normally present in the digestive tract (intestinal flora). EHR could also be related to environmental factors, not yet elucidated. Food stress and intolerance can trigger symptoms in some people, but these factors are not the cause of the disease.
The hemorrhagic ulcer is associated with joint (axial or extremity) disorders, skin (erythema nodosum), inflammation of the eyes, or liver problems (sclerosing cholangitis). These disorders related to the autoimmune reaction involved in the disease. The most severe acute complication of ulcerative colitis called “toxic megacolon.” It occurs when inflammation of the colon is so severe that the colon dilates and is susceptible to perforation. This causes severe pain, fever, vomiting, and swelling of the abdomen. A doctor consulted urgently in the presence of these symptoms in order to prevent the colon from perforating and peritonitis from occurring. Fortunately, this complication rarely occurs (in less than 2% of cases).
People with ulcerative colitis should be aware of the risk of anemia. Indeed, when the disease is severe, abundant blood loss to the point of causing anemia, which compensated by iron supplements. Several complications related to the long-term use of certain drugs, such as corticosteroids or immunosuppressants, may occur. Thus, long-term use of corticosteroids increases the risk of osteoporosis, cataract, hypertension, type 2 diabetes, etc. Corticosteroids and immunosuppressants may also increase the risk of infection.
Some populations are more at risk than others because of their genetic inheritance. Whites are 2 to 5 times more affected by ulcerative colitis than Blacks or Asians. The Jewish community (of Ashkenazi origin) is 4 to 5 times more affected by this disease than other populations. Up to 20% of people with ulcerative colitis have a close family member with Crohn’s disease or only 6% with ulcerative colitis, suggesting a genetic predisposition. If two parents affected, the risk of the occurrence of IBD during life would be 36%.
In the event of outbreaks of the disease:
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