Ulcerative colitis is a condition that encourages the development of ulcers in the lining of the colon, which subsequently influences the rectum and the sigmoid colon. It is expected that the severity of the disease is positively correlated with the area of the colon that has been affected the most.
Disease, Prevalence, and Incidence
Ulcerative colitis can be diagnosed in patients of any age; however, experts have not made a definite conclusion regarding the condition’s causes. In general, it is considered that the immune system may be the largest trigger for ulcerative colitis through having abnormal reactions to the presence of bacteria in the digestive tract. Also, genetics can play a role in increasing the likelihood of the disease; a patient is more likely to be diagnosed with ulcerative colitis if his or her relatives have been diagnosed with it.
According to the findings of the Centers for Disease Control and Prevention (2015), ulcerative colitis is more prevalent in males since females are more prone to having Crohn’s disease. The disease’s prevalence (number of existing cases) is 238 per 100,000 adult population (Centers for Disease Control and Prevention, 2015). The incidence rate (number of newly-diagnosed cases) is between 2.2 and 14.3 cases per 100,000 population (Centers for Disease Control and Prevention, 2015). Additional findings regarding the incidence and prevalence of ulcerative colitis include environmental, socioeconomic, and other factors. For instance, it has been found that the disease is more likely to occur among ex-smokers, citizens of developed countries that live an urbanized lifestyle, and those exposed to pollution and industrial chemicals. Also, ulcerative colitis is more likely to be diagnosed among patients of white-collar occupations who have a higher income. Other possible factors include taking oral contraceptives or having atypical infections; however, the impact of these variables has not been proven.
To understand what patients and healthcare providers go through when dealing with ulcerative colitis, it is important to give an example from practice. The case of Tahjae Nelson (aged 21, African American) was similar to the most instances of ulcerative colitis among patients of his age. Mr. Nelson reported severe pain in the abdomen (8 out of 10 points), bloody stools, and abdominal pain while eating food. The laboratory testing (biopsy and colonoscopy) showed active colitis, which had to be managed immediately. It worth noting that the patient did not have any allergies, had no previous history of illness; however, the disease progressed rapidly and occurred suddenly, pointing to the possible involvement of genetics.
Laboratory Testing
Endoscopy has been identified as the most common test for diagnosing ulcerative colitis. The testing will show the appearance of an abnormal erythematous mucosa (either with or without ulcerations) in the rectum or the colon (Basson, 2017). Also, the testing may show whether there is contact bleeding; a mucosal biopsy will let healthcare providers discover the severity of the condition to make final decisions on treatment.
FDA regulations propose two methods of assessing ulcerative colitis, such as histological assessments (biopsy of specimens) and the Mayo Scores (rectal bleeding, stool frequency, and endoscope subscores). With regards to regulations that support the introduction of new pharmaceutical agents, the FDA (2016) established a policy that forces to comply with the Pediatric Research Equity Act, therefore, to only use adequate data that supports the agents’ effectiveness and the safety.
Role of Finance
Because causes of ulcerative colitis have not been studied effectively, the sphere of healthcare requires substantial investments in the advancement of treatment. According to Peyrin-Biroulet (2013), new treatments for managing the disease can include the use anti-tumor necrosis factor agents, which means that some patients do not have to undergo colectomy. However, despite the array of possible directions in which the effective management of ulcerative colitis can go, grants and financial support for research are taken very seriously. For example, the Crohn’s and Colitis Foundation invests its funding in only the best and most promising research that can contribute to a scientific breakthrough. As of now, the Foundation played a significant role in generating research data that led to the discovery of the first inflammatory bowel disease gene.
Role of Families
In choosing a plan for treatment or making further decisions on the management of ulcerative colitis, the key responsibility belongs to healthcare providers who have solid knowledge of the most effective methods of treatment. It is rare that a patient’s family will make a decision about health care since symptoms of the disease can be extremely severe, leaving no time for consideration for the family. On the other hand, it is important to note that genetic factors are probably involved in the development of ulcerative colitis, which means that relatives are more likely to have the same condition. This suggests that similar methods of disease management can suit relatives. Also, it is essential to take into consideration that DNA research can lead to a significant breakthrough in the research of ulcerative colitis through studying evolutionary changes in an organism’s number of chromosomes.
Role of Genetics
Since genetics play a large role in the development of ulcerative colitis, but other factors can also contribute, the hereditary pattern linked to the disease can be considered multifactorial. This means that the disease is highly likely to develop on the basis of genetic factors that can be reinforced by environmental factors such as smoking or living a passive lifestyle. Studies that involved looking at associations between certain types of genes and their roles in encouraging the disease’s development found that genes that make it possible for the body to produce proteins to form protective barriers in the intestine can affect the occurrence of ulcerative colitis (Sampson, 2017). Another type of genes associated with ulcerative colitis influence the function of T cells, which aid the body to identify harmful bacteria and destroy them to prevent an infection from spreading. Therefore, if the genes responsible for the mentioned functions have specific variations that make them less effective in preventing the disease, it is highly likely that patients who possess such genes will inevitably be diagnosed with ulcerative colitis, especially if their relatives have also had it.
Conclusion
To summarize, ulcerative colitis is a well-known but understudied disease that has direct links to genetics and multifactorial hereditary patterns. Despite the fact that the causes of the condition remain to be further researched, the modern treatment advancements allow for an effective management of ulcerative colitis, especially with support from foundations that encourage innovative research in this area. It is important to remember that genetic conditions cannot be prevented; however, since the disease is likely to occur among patients younger than 30, it is important to consider clinical testing to ensure that the likelihood of occurrence is low or that the condition can be managed at its earliest stages.
References
Basson, M. (2017). Ulcerative colitis workup.
Centers for Disease Control and Prevention. (2015). Epidemiology of the IBD. Web.
FDA. (2016). Ulcerative colitis: Clinical trial endpoints. Guidance for industry.
Peyrin-Biroulet, L. (2013). Advances in the treatment of ulcerative colitis. Gastroenterology & Hepatology, 9(12), 827-829.