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Like Crohn's disease, ulcerative colitis is considered a chronic inflammatory bowel disease (IBD).
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In contrast to Crohn's disease, in ulcerative colitis, only the mucosa of the large intestine is systematically affected continuously from distal to proximal (i.e., in the direction towards the center of the body).
This chronic disease affects only the colon's outer wall layers (mucosa and submucosa). Other intestinal segments (e.g. small intestine) are not affected.
The symptoms (abdominal cramps, frequent bowel movements, and bloody diarrhea) are usually not permanent; rather, they flare up and subside again after some time. This often also occurs in strong episodes, where more violent symptoms (severe pain, high fever, heavy bleeding from the anus, and violent diarrhea).
The disease can start at any age, with an increasing incidence before the age of 30 and a decreasing incidence towards the 4th decade of life. White people of European descent living in Northern Europe are most commonly affected, with a strong clustering in Scandinavia.
Long-standing ulcerative colitis is associated with an increased risk of colorectal cancer.
A distinction is made between the two stages of the disease:
In the initial stage, inflammatory reddened mucosa and contact bleeding are observed, but no ulceration.
In the chronically advanced stage, ulcers develop, which affect deeper layers of the intestinal wall as well as the destruction of mucosa. Non-destroyed areas of the mucosa produce so-called pseudopolyps as a sign of regeneration and healing.
During violent episodes, the colon can swell so much that a small tear develops (perforation). This can cause stool to enter the abdominal cavity, which can result in a life-threatening infection. In most cases, ulcerative colitis shows a chronic-recurrent course, so that relapses can alternate again and again with phases of complete remission, often after psychological and physical stress situations.
Sometimes this symptom-free period can last for years. In about 10% of cases, however, there is no further recovery; this is referred to as a chronic-continuous course. Rarely (5%), an "acute fulminant" course is also observed with sudden onset, a painful urge to defecate or urinate, high fever, and even a shock reaction.
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Cause of ulcerative colitis
The causes have not yet been fully clarified by medical research. Autoimmune causes, genetic predisposition, but also disturbance of the intestinal flora and nutrition-related factors are discussed and researched for the emergence and development of ulcerative colitis. In addition, psychosomatic causes or infectious processes are also being considered.
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INUSpheresis® Use in autoimmune diseases
A useful complementary therapeutic measure for autoimmune diseases is INUSpheresis® , since the resulting malformed autoimmune antibodies can be washed out together with the inflammatory mediators.
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