Ulcerative Rectocolitis

What is it?

Ulcerative rectocolitis is a chronic inflammatory disease of the intestine that primarily affects young people at the age of 20 – 30. Although the causes of ulcerative rectocolitis have not yet been defined, it is known that several environmental, familial, and genetic factors may play a key role in its etiopathogenesis. At the base of the disease, there is an excessive activation of the immune system that leads to damage at the level of the rectum and can progress to affect the entire colon.

Which are the symptoms?

The main symptoms of ulcerative rectocolitis are diarrhea and the presence of blood or mucus in the stool. Fever, abdominal pain, weight loss and anemia also sometimes occur. In the most severe cases, if the disease is not recognized and treated in time, severe complications may occur such as fulminant colitis with abnormal dilatation of the colon, up to intestinal perforation. In addition to intestinal symptoms, extraintestinal manifestations such as joint pain, ocular or dermatological symptoms may also be present.

  • diarrhea
  • blood in the stool
  • fever
  • abdominal pain
  • fecal incontinence

How is it diagnosed?

The diagnosis of ulcerative rectocolitis is made on the basis of many factors that include symptoms compatible with intestinal disease, blood and stool tests indicative of inflammation (elevation of C-reactive protein and fecal calprotectin), radiological examinations such as CT scan to exclude any complications, and colonoscopy that allows to visualize any lesions of the mucosa of the rectum and colon and take biopsies of mucosal fragments in order to analyze them. 

Suggested exams

How is it treated?

Treatment of ulcerative rectocolitis depends on the severity of the disease. In milder forms, in fact, it is sufficient to take mesalazine, an anti-inflammatory drug, orally or rectally. In more severe forms, however, it is necessary to administer specific drugs that reduce the hyperactivity of the immune system (corticosteroids, immunosuppressants, biological drugs or small molecules) orally, subcutaneously or intravenously. Since it is a chronic disease, therapy must be taken long-term to maintain the therapeutic effects over time. In the most critical forms hospitalization may be indicated, and in rare cases even a surgical removal of the colon and rectum can be done. Ulcerative rectocolitis is associated with an increased risk of developing colon cancer and, therefore, periodic endoscopic examinations are necessary.

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