Ulcerative colitis: the most effective dietary supplements

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD), limited to the mucosa and continuously affecting the rectum and colon. This condition evolves in flare-ups, interspersed with periods of remission. Its exact origin is still poorly understood, but it is likely multifactorial, involving dysregulation of the immune system in response to environmental factors and the gut microbiota in genetically predisposed individuals.

Pathophysiology

The pathophysiology of UC involves several factors: • Genetics : A family history of IBD is the main risk factor. The risk of developing the disease is significantly higher in first-degree relatives of affected patients. • Smoking : Smoking is a protective factor against UC, unlike Crohn's disease. • Appendectomy : A history of appendectomy, especially before the age of 20, is associated with a less severe course of UC. • Gut microbiota : Dysbiosis, i.e., an imbalance between protective and pathogenic bacteria, is often observed in patients with UC.

Etiologies

The etiologies of UC are not yet fully elucidated, but several factors contribute to the development of the disease: • Genetic factors : Genetic mutations, notably those affecting genes involved in immune regulation, increase predisposition to the disease. • Environmental factors : Western lifestyle, characterized by processed foods and excessive hygiene, as well as the use of certain medications, are suspected to play a triggering role. • Immunological factors : UC manifests as a dysfunctional immune response, in which the immune system inappropriately attacks the cells of the intestinal mucosa, causing chronic inflammation.

Symptoms

Digestive : Bloody-mucous diarrhea, abdominal pain, tenesmus (frequent and painful urge to defecate), and cramping (abdominal pain followed by false urges). Extraintestinal : Scleritis, episcleritis, uveitis (inflammation of the eyes), erythema nodosum (skin inflammation), and primary sclerosing cholangitis (inflammation of the bile ducts). Impairment of general condition : Fever, anemia, fatigue.

Complications

The complications of UC can be severe: • Severe acute colitis : A medical-surgical emergency, it can lead to colonic dilation (toxic megacolon) or colonic perforation. • Increased risk of colorectal cancer : Especially in pancolitis (extensive colonic involvement) and in patients with associated primary sclerosing cholangitis. • Deep vein thromboses : Increased thromboembolic risk during flares.

Treatment

The treatment of UC aims to control inflammatory flare-ups and maintain remission: • Salicylate medications (5-ASA) : First-line treatment for mild to moderate forms. They can be administered orally or locally. • Corticosteroids : Used to induce remission during moderate to severe flares. • Immunosuppressants (thiopurines) : Indicated in cases of steroid dependence or steroid failure. • Biologic therapies (anti-TNF alpha, vedolizumab) : Used in severe refractory forms or to maintain remission in steroid-dependent patients. • Surgery : In cases of complicated severe acute colitis or resistance to medical treatment, colectomy may be necessary.