Ulcerative Colitis – symptoms, analyzes
Symptoms of ulcerative colitis
Symptoms that dominate the clinical picture are diarrhea with mucus, blood and pus. Other symptoms are abdominal cramps, tenesmus (intense feeling to defecate).
The abdominal examination reveals a pain in the hypogastric area (area under the navel) and in areas where colon is projected.
Periods with diarrhea consist of diarrhea stools for up to 10 times a day. In a more severe case, the stool consists only of blood, mucus and pus. Outside periods of crisis, everything is close to normal, the stools are of normal appearance, maximum 3 a day and no longer contain blood.
Symptoms that are not related to the digestive tract: anemia (occurs because of chronic blood loss – lose iron), fever (usually during disease activation), weight loss, fatigue. Other signs: arthritis, erythema nodosum, uveitis.
Analysis and imaging investigations in ulcerative colitis
The laboratory analysis show: iron deficiency with anemia (iron loss), low sideremia, low albumin, increased ESR, leukocytosis (leukocyte number is above normal), increased CRP. To eliminate a possible cause of a bloody diarrhea it is made a stool analysis (this will exclude bacterial dysentery).
Colonoscopy is mandatory. With it you can make the correct and accurate diagnosis by the typical appearance of recto-colonic mucosa. Colonoscopy helps us to take a biopsy which will then be examined by a pathologist. The appearance of the mucosa: mucosa is friable, shows ulcerations, diffuse erythema, looks like a mucosa which “cries blood” and is covered by mucous and pus. Colonoscopy will explore the colon completely, but will not be a total colonoscopy, only in periods of remission.
Irigography is rarely done these days, only in chronic forms when appear obvious changes. Mucosal appearance at irigography will be granular, with false polyps, colon has a tubular aspect.
Abdominal ultrasonography may indicate bowel wall thickness. It is performed during periods of ulcerative colitis activation when colonoscopy carries risks. Extension of the colon inflammation is done by measuring wall thickness (which has more than 5 mm in thickness). To observe these changes the doctor performing ultrasound needs more experience.