Ulcerative colitis etiology

There are two forms of idiopathic inflammatory bowel disease (IBD) ulcerative colitis, a mucosal inflammatory condition confined to the rectum and colon, and Crohn s disease, a transmural inflammation of GI mucosa that may occur in any part of the GI tract. The etiologies of both conditions are unknown, but they may have a common pathogenetic mechanism. 

Inflammatory bowel disease (IBD) comprises two distinct disorders ulcerative colitis and Crohn s disease. The etiology and pathogenesis of these disorders remains unknown. For this reason, pharmacologic treatment of inflammatory bowel disorders often involves drugs that belong to different therapeutic classes and have different but nonspecific mechanisms of anti-inflammatory action. Drugs used in inflammatory bowel disease are chosen on the basis of disease severity, responsiveness, and drug... 

Mental health changes appear to correlate with remissions and exacerbations, especially of ulcerative colitis, but psychological factors overall are not thought to be an etiologic factor. There is a weak association between the number of stressful events experienced and the time to relapse of ulcerative colitis. ... 

Parenteral nutrition is an important component of the treatment of severe Crohn s disease or ulcerative colitis. The use of parenteral nutrition allows complete bowel rest in patients with severe ulcerative cohtis, which may alter the need for proctocolectomy. Parenteral nutrition has also been valuable in Crohn s disease, because remission may be achieved with parenteral nutrition in about 50% of patients. In some patients, the disease may worsen when parenteral nutrition is stopped. Patients with enterocutaneous fistulas of various etiologies benefit from parenteral nutrition. Parenteral nutrition may also be valuable in children or adolescents with growth retardation associated with Crohn s disease, but surgery is often necessary with severe disease. Finally, when possible, home parenteral nutrition should be used for patients requiring long-term therapy, particularly those with short gut as a consequence of surgical resection. 

Clinical herbalists have reported differing information on the use of Echinacea species in autoimmune conditions. Exacerbation of symptoms has been reported in systemic lupus, ulcerative colitis (autoimmune etiology uncertain), glomerular nephritis, and multiple sclerosis. In "some" cases, effects reoccurred on rechallenge. In rheumatoid arthritis, treatment with Echinacea species for 10 days did not exacerbate the condition (Upton and Graff 2007). A survey of 25 medical herbalists indicated that 12 had used Echinacea species in persons with autoimmune conditions. Of these 12, 11 indicated a beneficial effect and 1 indicated a worsening of symptoms (Upton and Graff 2007). 

In 1961, Truelove reported that some cases of adult ulcerative colitis are provoked by milk. In recent unpublished studies, we have observed several adult patients with ulcerative proctitis induced by food, who have had marked rectal mucosal eosinophilia and other atopic diseases. Significant eosinophil infiltration is a recognized feature in a proportion of patients with colitis but further work is required before it is known whether this reliably indicates a subgroup of adult patients with an allergic etiology. 

Inflammatory bowel disease (IBD), alongside Crohn s disease (CD) and ulcerative colitis are characterized by the inflammation of the gastrointestinal tract. The etiology of IBD is induced by a combination of factors that contributes to this pathogenesis. 

Inflammatory bowel diseases (colitis and Crohn s disease) Clearly, inflammatory conditions have an immune component. In the case of Crohn s disease, there appears to be no established therapeutic or etiological role for fiber. The situation is slightly different for distal ulcerative colitis, in which fiber intake seems unrelated to incidence. However, rectal infusion of SCFAs (especially butyrate) has been reported to lead to remission, so it appears that either the generation of these acids or their delivery to the distal colon may be the issue. 

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