Jan 012015
 

Ulcerative Colitis


Ulcerative Colitis is a recurrent and inflammatory usually chronic disease that affects the mucosal and sub mucosal layer of the colon and rectum. It invariably begins in the rectum and sigmoid colon and commonly extends upwards into the entire colon, rarely affecting the small intestine.

ulcerative colitis

Ulcerative Colitis

Ulcerative Colitis can be a serious disease if not treated on time and this disease is found more in mature age but it may be found in some children in US too. It is said to be Ulcerative Colitis, when there is chronically inflammation of colon or intestine. It starts from ulcer in the colon and accompanied with inflammation and seen the symptoms like abdominal pain, rectal bleeding, diarrhea etc. Similarly, there may also observed the inflammation of spine, joints, skin, liver, eye and bile duct.

Ulcerative Colitis produces edema (leading to mucosal friability) and ulcerations. Severity ranges from mild, localized disorder to a fulminant disease that may cause a perforated colon, progressing to potentially fatal peritonitis and toxemia. The disease cycles between exacerbation and remissions.

Ulcerative Colitis

Ulcerative Colitis

Since Ulcerative Colitis is related to large intestine, it can be cured by doing surgery of large intestine in the severe cases. The surgery includes the colectomy where the infected parts is removed and again join with the healthy parts. If it is not a severe case, we can treat it with anti-inflammatory drugs, immuno-suppression, biological therapy targeting specific components of the immune response.

Incidence and Causes of Ulcerative Colitis

Incidence:

  • Highest in caucasions & people of Jewish Heritage
  • High mortality rate.
  • 10 to 15% of the patient develops carcinoma of the colon.
  • Occurs primarily in young adults, especially women.
  • More prevalent among Ashkenazim & in higher socio-economic groups.
  • Onset of symptoms seem to peak between ages 15 & 12 and between the age of 55 & 60.

Causes:

  • Unknown.
  • May be related to;
    • Abnormal immune response in the GI tract.
    • Bacteria – E. coli.
    • Food.
    • Genetic factors
    • Environmental factors

Pathophysiology for Ulcerative Colitis

  • Ulcerative Colitis usually begins in the inflammation in the base of the mucosal layer of the large intestine.
  • The colon’s mucosal surface becomes dark, red & velvety.
  • Leads to erosions that coalesce and form ulcer.
  • Mucosa becomes diffusely ulcerated in hemorrhage, congestion, edema and exudative inflammation.
  • Continuous ulceration.
  • Abscesses in the mucosa.
  • Drain purulent exudates, become necrotic and ulcerate.
  • Sloughing causes bloody mucus filled stool.
  • Scarring & thickening appear in the bowel’s inner muscle layer.
  • As Granulation tissue replaces the muscle layer, the colon narrows, shorten and loses its characteristics pouches.
  • Leads to intestinal obstruction, dehydration fluid & electrolyte imbalances, hemorrhage.

Clinical Manifestations for Ulcerative Colitis

  • Clinical course is usually one of exacerbations & remissions predominant symptoms are:
  • Diarrhea (Recurrent bloody diarrhea as many as 10-20 stools per day) typically containing pus & mucus (hallmark sign) from accumulated blood & pus-mucus in the bowel.
  • LLQ pain –> abdominal cramping and rectal urgency from accumulated blood & mucus.
  • Intermittent tenesmus –> sensation of desire to defecate.
  • Rectal bleeding –> bleeding may be mild or severe & pallor results.
  • Anorexia.
  • Weight loss secondary to mal-absorption.
  • Fever.
  • Vomiting.
  • Dehydration.
  • Hypocalcaemia & anemia.
  • Rebound tenderness on RLQ.
  • Extra-intestinal symptoms.
    • skin lesions (Erythema nodosum)
    • eye lesions (Uveitis)
    • joint abnormalities (arthritis)
    • liver disease.
  • Weakness related to possible mal-absorption and subsequent anemia.

Assessment and Diagnostic findings for Ulcerative Colitis

  • History taking.
  • Physical examination.
  • Laboratory findings.
  • Serology shows decreased serum potassium, magnesium and albumin levels.
  • Stool specimen analysis reveals blood pus & mucus but no disease causing organisms.
  • Sigmoidoscopy confirms rectal involvement, specifically mucosal friability & flattening and thick inflammatory exudates.
  • colonoscopy reveals extent of the disease, stricture areas, and pseudo polyps (not performed when the patient has active s/s)
  • Biopsy in colonoscopy confirms the diagnosis.
 Posted by at 8:28 am
Aug 152014
 


ebola-disease1There are many types of diseases in the world which are affecting the living organisms. Merriam-Webster defines ‘disease’ as an impairment of the normal state of the living animal or plant body or one of its parts that interrupts or modifies the performance of the vital functions and it is typically manifested by distinguishing signs and symptoms, and is a response to environmental factors (as malnutrition, industrial hazards, or climate), to specific infective agents (as worms, bacteria, or viruses), to inherent defects of the organism (as genetic anomalies), or to combinations of these factors. These days, due to different factors such as pollution, use of toxic materials in food, genetic factors etc. people are suffering from many diseases. The world has already seen the outbreaks of different diseases like Influenza, Swine Flu etc. in the past. Now, ‘Ebola Hemorrhagic Fever’ has taken over the globe. Its outbreak has brought out a revolution in the minds of the people. Every nation is trying its best to save its people from this disease since it is a dangerous as well as a fatal disease.

Ebola hemorrhagic fever, also known as Ebola virus infection,  is a disease that occurs in humans and primates like monkeys and gorillas. It is also known as Viral hemorrhagic fever. Due to its destructive potential, it is considered to be one of the most dangerous and fatal diseases of today’s time. The first case of Ebola was observed on 26th August, 1976 in Democratic Republic of Congo (then known as Zaire). This is a disease that affects its victims by making them bleed from almost any part of their body. The fruit bats of Pteropodidae family are considered to be the natural host of this virus.

Cause

Ebola hemorrhagic fever, also known as Ebola fever, is caused by a virus that belongs to the family called Filoviridae and order Mononegavirales. The species in this genus are called ebolaviruses. There have been identified five types of Ebola virus till date. They are Zaire ebolavirus, Sudan ebolavirus, Taï Forest ebolavirus, Bundibugyo ebolavirus and Reston ebolavirus. Among these, four are reported to cause disease in human beings, i.e. Zaire ebolavirus, Sudan ebolavirus, Tai Forest ebolavirus and Bundibugyo ebolavirus.

Mode of transmission

Ebola is transmitted through close contact with body fluids like blood, sweat, saliva, semen or other body discharges. Luckily, Ebola is not an air-borne virus. It is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.

Incubation Period

The incubation period of Ebola hemorrhagic fever is from 2 to 21 days.

Symptoms

The symptoms of Ebola hemorrhagic fever are given below:Symptoms_of_ebola

  • Arithritis, which is the inflammation of the joints
  • Pain in lower back region.
  • Nausea and vomitting
  • Fever
  • Fatigue
  • Headache
  • Sore throat
  • Chills, which is the feeling of coldness even during high fever
  • Lack of appetite
  • Stomach pain
  • Weakness

These are the primitive symptoms of this disease. The late symptoms are:

  • Bleeding from sense organs like eyes, ears and nose
  • Gastrointestinal bleeding, in which bleeding occurs from the mouth and rectum
  • Conjunctivitis or swelling up of eyes
  • Swelling up of genital organs (labia and scrotum)
  • Pain in the skin
  • Bloody rashes occur over the entire body
  • The roof of mouth looks red

The signs of coma, shock (a life-threatening condition that occurs when there is no sufficient blood flow in the body) and disseminated intravascular coagulation (DIC) can be seen. Disseminated intravascular coagulation is a disorder in the body due to which unnecessary blood clotting takes place in the body. This may even stop the blood flow.

Treatment

Unfortunately, there is no specific treatment for Ebola hemorrhagic fever till date. The treatment is primarily of supportive type which includes minimizing the invasive effect of the virus, balancing fluids and electrolytes to check dehydration, administration of anticoagulants at the time of infection to prevent disseminated intravascular coagulation, administration of procoagulants later to control bleeding, maintaining oxygen levels, pain reduction and the use of medications to treat infections by other bacteria and fungi. There are chances of survival if the patients are treated at the early stage.

Preventive measures

The preventive measures of Ebola hemorrhagic fever are:

  • Avoiding unnecessary physical contact with people.
  • Limiting ourselves to food made at home only.
  • Disinfecting the surroundings since the virus cannot survive heat, direct sunlight, detergents and soaps.
  • Washing hands regularly.
  • Fumigation of pests.
  • Destruction of rodents.
  • Creating awareness among the people.