 Authentic colitis is one of the inflammatory bowel disorders closely related to Crohn's disease, but there are some similarities, but also some differences. So let's look at this initially. So it is an inflammatory bowel disease, IBD, and there are typically some episodes of exacerbation as well as remission, and it is an autoimmune disease, and those are the similarities with Crohn's disease. However, ulcerative colitis, again the word gives it away, ulcerative, there are ulcers in the colon and it is the inflammation. So ulcerative colitis only affects the colon when Crohn's disease affects the entire GI tract. Now the difference is also that in ulcerative colitis typically the inflammation starts at the rectum and it kind of works its way up the digestive tract, when Crohn's disease is more in dispersed in different parts of the GI system, it doesn't start in one location and then it starts to spread, and there are continuous areas of inflammation in ulcerative colitis where again in Crohn's disease it's more kind of like interspersed at different locations throughout the GI system. Risk factors for developing ulcerative colitis include the environment, such as exposure to toxins or pollution, smoking is a big factor, genetics play a role as well as in all autoimmune disorders, other immune disorders for patients at risk for developing ulcerative colitis, and then a diet high in meat and high in fat definitely is also a contributing factor to developing this inflammatory bowel disorder. Now signs and symptoms vary from Crohn's disease where there are a lot of times in ulcerative colitis there is a lot of blood in diarrhea and this puts the patient at risk not only for anemia from all this loss of blood but also because with the diarrhea lots of fluids and electrolytes can be lost so the patient is at risk for dehydration as well as electrolyte losses. There might be severe abdominal pain during the attacks the patient might have a fever from this inflammation of the colon and then there is this term called tinnismus which is basically a cramping type of abdominal pain as the patient is trying to defecate and the colon is so inflamed it kind of causes a spasm, this cramping sensation at the rectum. I already mentioned anemia and anorexia are concerns as well as dehydration and then certainly if there is a lot of diarrhea and the colon is so inflamed it can lead to weight loss as well. As for diagnostic tests we want to check a CBC and many times patients will be iron deficient and have iron deficiency and anemia. We want to check their CMP to check for those fluid and electrolyte imbalances as well as the kidney and liver function to see maybe they've got to a certain degree of dehydration when their kidneys are suffering. Certainly ESR and CRP those inflammatory markers are going to be elevated, sometimes we need stool cultures to rule out other diseases that might be causing infectious diarrhea for example. A barium enema bowel series might be needed to where we can visualize what's going on with the colon from that contrast here, ultrasound CT and MRI scans are also helpful as well as a colonoscopy to actually visualize the inside of the colon to see what's going on there and then a hemocard will determine if there is blood in the stool, if it's not this obvious bloody diarrhea. Complications of ulcerative colitis include an increased incidence of C. diff because now the colon wall is so inflamed that it throws off the normal gut bacteria and C. diff is basically an overgrowth of the not so good gut bacteria and then the patient can have C. diff infections on top of that which then again put them at risk for dehydration because C. diff causes lots of diarrhea, this mucus screen malodorous stool passing along with the regular diarrhea that sometimes can be bloody so we have to really be aware that these patients could be at higher risk for fluid and electrolyte imbalances and then the colon when it gets so inflamed it can perforate due to this toxic mega colon so now one area of the colon gets so inflamed that it kind of gets constricted which then backs up the colon that's proximal to that stricture site and then that can kind of burst and open up when that perforates it leads to leakage of the stool or the fecal matter into the peritoneum and can cause peritoneitis and I'll discuss this in a separate video. And then unfortunately patients with ulcerative colitis as in any chronic inflammation are at higher risk of developing colon cancer 10 years after the diagnosis so the longer this episode goes on and these exacerbations the more information there is the higher the risk of developing cancer. Now in terms of treatments the goal here trust like in Crohn's disease is to decrease the episodes of exacerbation so we need to make sure the patient needs an adequate diet rich in iron and high nutrient very nutrient dense we need to decrease any environmental pollutants smoking any of those risk factors and we need to make sure the patient gets plenty of rest because during the episodes of exacerbations this can certainly be very fatiguing for the patients. Medications are focused on suppressing doing the immune system because it is an autoimmune disorder and again there are five different categories of immune drugs that can be used so first of all there are immunosuppressants certainly we'll need antibiotics if there's an underlying infection such as C. difficile then steroids again decrease the inflammatory response as well as a drug category called five amino acid salicates and biologics and those are very specialized drugs that typically you won't need for your basic nursing degree if you were to get a job in GI where you have a lot of patients with these kind of disorders you'll know more about these drugs but just know that there's different categories of immunosuppressants as important here. In terms of nutrition we want to make sure the patient eats a well balanced and healthy diet that is high in calories and high in protein and high in nutrients so lots of good healthy nutrition again low in fat and low in meat. Now sometimes when these episodes of exacerbation gets so severe that the colon is really inflamed and there's a lot of damage down there a total proctocollectomy can be done and that is the removal of the rectum and the colon and because ulcerative colitis is only localized in the colon if the rectum and the colon are removed that basically removes the disease so total proctocollectomy is curative and there are two options here first is a total proctocollectomy with an ileal pouch or an anal anastomosis so basically now the since the colon the rectum are removed the end of the small intestine the ileum will be the last part of the patient's digestive system and that is then connected to the anus so the ileal pouch and anal anastomosis meaning the connection of two pieces and that means that the patient still has control at the anal sphincter so basically we're just removing that part of the digestive system putting these other two parts together and the patient is still able to have regular bowel movements through the anus where if there is a total proctocollectomy with a permanent ileostomy that means that this anastomosis has not been successful or attempted for any reason that might be anatomical differences or any kind of other complications that the patient has then they need to have a permanent ileostomy where now the terminal ileum is where that's brought to the surface and the patient will have an ileostomy back there that's very similar to a colostomy back where the stool basically just exits through the abdominal wall and is collected in the back so thank you for watching this video on also difficulties please also make sure to watch the video on Crohn's disease so that you are aware of the similarities but also the differences between those two inflammatory disorders and then also watch my upcoming video on peritonitis that can be a complication of not only inflammatory bowel disorders but a variety of other GI disorders please subscribe give me a thumbs up and I'll see you soon here on nursing school explain thanks for watching