So what is IBD?
The rectum is always affected and is called proctitis.
It may extend further along the left side to the splenic flexure, when it is know as distal colitis.
The whole of the large intestine may be affected and the condition is known as pancolitis.
Ulcerative colitis is a chronic disease with periods of remission, in which patients are symptom-free, and relapses in which symptoms flare-up.
The onset may be gradual or sudden.
Medical treatment is successful in keeping most patients in remission until the disease slowly burns itself out. However, occasionally, surgery may be necessary.
Investigations (tests) are necessary to reach the correct diagnosis and to check on the progress of the disease.
After an initial examination in the clinic, some of the following tests may be performed:
1. Blood tests
a) to check for anaemia. Full blood count – FBC)
b) to check the proteins in the blood
(i) a low level of albumin in the blood suggests severe ulceration
(ii) a raised ‘C’ reactive protein reflects inflammation
c) to check the state of the liver. (Liver function tests – LFTs)
d) to see if there is an imbalance of salt and water due to diarrhoea. (Urea and electrolytes)
2. Stool tests
A relapse may be due to infection and this can be excluded by looking for bacteria in the stool.
An examination of the lower bowel with a rigid metal tube that has a light on the end. Small pieces of tissue called biopsies may be taken for examination under the microscope.
4. Plain abdominal film
Straight Xray of the abdomen may show swelling and obstruction of the bowel or constipation.
5. Barium Xrays
Barium sulphate is a liquid which shows up on Xray and can therefore be used to demonstrate the bowel which is otherwise poorly seen. It may be given by mouth to examine the small intestine or by enema to examine the large intestine.
An examination in which the large intestine (colon) is examined by a long, flexible, fibre optic (fibres which carry light) telescope called a colonoscope.
Biopsies may be taken for examination under the microscope.
7. White cell scan (leucocyte scan)
A scan in which the patients’ own white blood cells, labelled with a tiny amount of radioactivity, are used to show the extent and severity of inflammation.