Colon cancer (colorectal cancer)

Colorectal cancer is for both men and women the second most common cancer.Men are affected on average with 69 women with 75 years - that is comparatively late. Colorectal cancer is also for both sexes is the second most common cause of cancer death.

must die of cancer are now unable

More and more of those affected survive colorectal cancer: 5-year survival rate in recent years has risen to 60 percent. The rate would be even higher if more people would take the colorectal cancer screening to complete. Unfortunately, they use far less than 30 percent of the insured. This cancer in 95 percent of the cases can be cured as it passes through one check-up (or rather, early detection) is detected at a very early stage. To improve the early detection rate, organized by the Felix Burda Foundation (FBS) in conjunction with the German Cancer Aid, the German Cancer Society and the gastronomic league every year in March, a nationwide awareness campaign about cancer.

Test for colorectal cancer screening with blood in the stool and colonoscopy

The simplest and cheapest method of early detection is the test for hidden blood in the stool, the Hemoccult test (FOBT after the guaiac method). The safest method is colonoscopy (colonoscopy), you can use to detect almost all tumors. Colonoscopy is aged 55 Of life, a standard benefit of the statutory health insurance funds.


Cancer therapy: In the early stage is often an operation

The main treatment for colon cancer is surgery. Depending on where the tumor is located, a section of intestine is removed. In the early stages, an additional radiotherapy or chemotherapy is usually not necessary.

The intestine: anatomy and function

The human intestine is divided into three sections:

• the small intestine
• the colon
• the rectum

In the small intestine, food is broken down into simple components that can be absorbed by the epithelial cells of the intestinal mucosa. It has a length of about four meters. The small intestine starts after the pylorus to the short duodenum (duodenum), which the long, winding sections of the jejunum (jejunum) and ileum (ileum) to connect to. To increase the resorption of the nutrients the mucous membrane with many small villi is busy.

The large intestine (colon) has a length of 1.5 to 2 meters. Its role is mainly the absorption of water, that is, it thickens the intestinal contents. He outlined the small intestine like a frame and starts in the right lower abdomen with the cecum (cecum), on which side of the appendix (Appendix) depends. On the right side of the abdominal colon rises upward (ascending colon), runs below the liver after a bending cross to the left side of the abdomen (transverse colon) and went to another bend in the descending part (descending colon) on. Following this is the approximately 20 centimeters long S-shaped Sigma intestine (sigmoid colon), which the bowel (rectum) becomes. Here, the manure is collected. A system of muscles closes the intestine to the outside and prevents involuntary defecation. At a certain filling bowel movement is triggered, leading to a controlled defecation.

The inner surface of the intestine consists of a squamous cell layer, are embedded in the mucous glands. The slime formed by it makes the slippery mud.Longitudinal and transverse muscle layers in the gut provide for intestinal movements (peristalsis) through which the intestinal contents are transported.
Bowel cancer: How does a tumor?
In one tumor formation initially a lesion occurs in a group of cells, such as the squamous cell layer. These cells begin to divide uncontrollably and form a tumor (tumor).

Their behavior to divide the tumors into:

• benign (benign)
• malignant (malignant)

Benign tumors grow slowly and usually are usually well defined, for example, with a capsule. They do not form secondary tumors to grow and also not in other organs.

Malignant tumors are characterized by rapid, unfettered growth into adjacent tissue, the organ boundaries from over. They destroy the fabric and then grow into blood and lymph vessels. Thus, individual tumor cells via the blood vessels in lymph nodes or organs are taken away, where secondary tumors (metastases).

A cancer tumor is "malignant" (malignant) tumor.

can the real cause for the development of tumors is due to the change in the genetic material of cells, responsible for internal and external factors are. The external factors include tobacco smoke, certain chemicals, radiation, UV radiation from the sun or viral infections, and malnutrition. We now know that a low-fiber, fat and meat-rich diet increases the risk of bowel cancer. A certainpredisposition plays a role in cancer development.
In a disturbed immune system cells, the degenerate not diagnosed or off. The ageof the people plays a role. With increasing age, the ability to fix certain errors that have occurred in the genetic material of cells. Therefore, cancers are more common in older age.

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Diagnosis of Crohn's disease: ultrasound

During ultrasound examination, also called sonography, the body tissue of a certain frequency sound waves will be suspended. If these waves in boundary layers of tissues of different densities, they are at least partially reflected as an echo, which contains lots of information about the location, size and condition of the treated organs. The ultrasound device converts this information to be in a gray-scale image.

Abscesses can be seen with ultrasound very well 

The ultrasonic method can indeed be no mucosal changes, but inflammatory bowel wall thickening, stenosis , fistulas and abscesses identified. Abscesses are seen with the ultrasound even better than the endoscopy, because the ultrasound also allows a view into the adjacent tissue of the intestine. Experienced doctors can use ultrasound to also assess the motor function of the intestine.

The ultrasound is simple and does not burden 

The other advantages of the ultrasound examination: Ultrasound is not stressful for the patient, can be done quickly and as often as required. The course of the disease and any acute complications can, therefore, well recognized by ultrasound. For initial diagnosis of Crohn's disease, the findings of ultrasound examination alone are not descriptive enough.
Diagnosis of Crohn's disease: X-ray, MRI and CT
With the widespread use of endoscopic procedures, the classical X-ray examination in the diagnosis of chronic inflammatory bowel diseases has declined in importance. It remains important but still, if to be examined for a suspected Crohn's disease, the conditions in the small intestine. Radiologists and share in this case increasingly as magnetic resonance imaging (MRI) instead of the conventional X-ray investigation. MRI has the advantage that it entails no radiation exposure.

Sellink MRI suitable for initial diagnosis 

For a gut-MRI, the patient a contrast agent to the intestine, the radiologist may well differ from the surrounding tissue. The contrast agent binds to the intestinal wall and makes the contours dar. In this double-contrast examination, including MRI Sellink called, can detect an inflammatory infection of the intestinal wall well. The Sellink MRI has another advantage: the radiologist can see not only the intestine but also the surrounding tissues well. Thus, for example Darmverwachsungen determine the peritoneum.

When bowel obstruction is suspected, contrast agent banned

For very specific questions - such as after a Fistelverlauf or an abscess - the radiologist takes an ordinary non-contrast MRI before. With a suspicion of a bowel obstruction (ileus), an intestinal perforation or severe colon expansion(megacolon) contrast agent is the administration of oral explicitly forbidden.Computed tomography (CT) may for a suspected abscess , bowel wall thickening and stenosis of unclear findings or to be. The CT is, however, as the conventional X-ray associated with exposure to radiation.

Diagnosis of Crohn's disease: gastrointestinal mirroring

The colonoscopy (colonoscopy) is the safest method to detect Crohn's disease. In these methods, the doctor a tube-like instrument (endoscope) into the digestive tract, which provides a tiny camera images from the interior of the organs. As can occur in Crohn's disease the inflammation in different places - in the small intestine, large intestine, and in rare cases even in the esophagus or stomach - is at the beginning of a gastroscopy (endoscopy) is necessary.

The gastroscopy, it is possible that the esophagus, stomach and the upper portions of the small intestine (duodenoscopy) inspect. At the same time, the doctor with very fine forceps, which run within the endoscope, remove tissue samples (biopsies) from the mucosa. For gastroscopy you need a hose to swallow the endoscope. A sedative such as diazepam and local anesthesia of the pharynx will facilitate the investigation. From the night before, you may take no more food to him.

The doctor may remove tissue samples from the gut 

During the colonoscopy, the doctor pushes the endoscope through the anus into the digestive tract. With the help of the colonoscopy can be fattening and colon and to investigate the last inch of the lower small intestine. In addition, the physician - remove tissue samples - as in the gastroscopy.

Before Colonoscopy a thorough bowel cleansing is necessary. Since the intestinal dubbing is often perceived as very unpleasant, leading doctors to study in some cases, even under general anesthesia.


Interest Tino copy allows a view of the entire small intestine 

Endoscopy has limitations when, as in Crohn's disease and the average small intestine sections must be examined. Recently there is the interest Tino copy and double-balloon endoscopy procedure, however, allow an inspection of the entire small intestine. called The Interests Tino copies, including enteroscopy, allows the duodenum (duodenum) and the upper portions of the following jejunum (jejunum) inspect. The double-balloon enteroscopy offers the possibility of stenosis(narrowing) widen. Both investigations are very time consuming.

A capsule endoscopy in Crohn's disease is only allowed if the physician has been excluded by narrow intestine. In this study, the capsule camera is also known as the patient swallows a miniature video camera. The camera records images during gut passage of the mucosa.

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Crohn's disease (chronic intestinal inflammation)

Crohn's disease (chronic intestinal inflammation)

Crohn's disease is a disease of the digestive tract, which was first described in 1932 in a trade journal, named after one of the authors. Together with ulcerative colitis, Crohn's disease is a chronic inflammatory bowel disease. The patients - mostly young people between 15 and 30 - suffer primarily from abdominal pain, diarrhea and general side effects such as fever and inefficiency. In Germany, approximately 150,000 people are affected by Crohn's disease.

Crohn's disease is often diagnosed only after years

In the course of the disease, which is also known as Crohn's disease known to alternate with periods of high complaints from largely symptom-free intervals. At the same time, many patients also occur in diseases outside the colon, such as arthritis and reddish-nodular changes on the lower legs (erythema nodosum). The symptoms are so very complex. Be between the first appearance of symptoms and the diagnosis Crohn's disease for several years. For the patient this is a time visits to the doctor more frequently and research . Often suffers from his psyche. Effective drugs for a new life Although the cause of Crohn's disease to date is not known, there are now very effective medications with less side effects than cortisone and patients often live a normal life permit.

Healthy lifestyle slows Crohn's disease relapses A balanced life contributes to the well-being and can reduce the number of relapses. Diet also plays a role: It is helpful to-eat vitamin, mineral and protein-rich to avoid malnutrition. It is very important also not to smoke. Smoking harms not only - as already known - vessels and airways: In Crohn's patients appeared to smoking aggravates the pain and increases the number of relapses.


Crohn's Disease: Causes

In Crohn's disease, it is difficult to identify the causes. Are you are still not sure.However, the disease mechanism is now widely known: intestinal specialists assume that it is a genetically determined disease. This means there is a predisposition to Crohn's disease. The lifestyle, nutrition and psychological factors as the cause of the disease is not an object. In many diseases are often specific factors that best promote their development. For example, is known to promote obesity, diabetes, fatty foods and lack of exercise.
The immune system is disturbed

In Crohn's disease is a morbidly excessive response of the immune system. The barrier function of the intestinal wall is disturbed: enabling bacteria of the normalintestinal flora enter the body and cause an inflammatory reaction. A turn genetic dysregulation of the immune system leads to the fact that this immune response persists and the inflammation becomes chronic.
The intestinal flora and bacteria play a role

This genetic component may be a decisive factor, but not the sole trigger for Crohn's disease. Thus, in identical twins only 58 percent of cases, both affected siblings. Obviously, the nature of the intestinal flora also plays a significant role. It has been found that regressing the inflammation in animals as soon as the intestinal lumen of germfree holds, then kill any bacteria. This is of course only possible in humans. Good results are possible, for example with a colostomy (stoma), because the underlying bowel comes to rest. Also, broad-spectrum antibiotics show good results, but they are not suitable for long-term therapy.Maybe even in Crohn's disease probiotics helpful.
Crohn's disease: complications
Patients with Crohn's disease are often not provided with sufficient essential nutrients. Because of the diarrhea and inflamed sections of the digestive tract, the nutrients in the gut are not absorbed as well. In addition: Chronic inflammation consume energy - they rob the body of calories and nutrients.

Other causes of poor nutritional status of Crohn's disease patients are: 

• Anorexia
• any bottlenecks in the gut
• or the surgical removal of intestinal segments

The consequences range from weight loss, the loss of fat and muscle mass to symptoms of vitamin deficiency. So there may be a lack of calcium come, bone metabolism affects. Often patients have Crohn's also a lack of vitamin B12 of blood disorders leading to.

More than every second patient has osteoporosis

A common and dreaded consequence of Crohn's disease is osteoporosis . In this disease decreases bone density, which is why falls can easily lead to breakage. In advanced stages, are already possible with the smallest impact fractures. About 60% percent of all Crohn's patients are probably affected by osteoporosis.

The causes are many: 

• the poor nutrient absorption through the gut
• the bone-depleting effect of the inflammation itself
• the corticosteroid therapy
• a milk intolerance, which is in Crohn's disease patients quite often.

In children and adolescents can lead to osteoporosis, growth retardation, and a delayed onset of puberty is discussed.

Dieticians recommend the 

For Crohn's disease patients and doctors, it is important to look for possible nutritional deficiencies and to balance them. A dietitian and a special nutritional therapy is useful in any case, especially if your body mass index below 18. If more than 10 percent of your weight within 6 months or have lost your serum albumin level is too low, the nutrition education is a must.

Crohn's Disease: Complications

Crohn's disease - unlike ulcerative colitis - in all regions of the digestive tract occur in principle. The infection is typically not limited to a section, that is, healthy and inflamed sections alternate. Another difference with ulcerative colitis: In Crohn's disease suffer all the wall layers of the digestive tract. It is therefore often a narrowing of the digestive tract (stricture). In about 10-15 percent of patients make transitions into the adjacent tissue (fistulas). Also a collection of pus (abscess) is possible.

Stenosis: Often, surgery is necessary

If heal Crohn's disease, the mucosal inflammation, often left scars. In severe cases, these scars are so severe that it restricts the cavity. This can hinder the transport of the chyme. In the worst case, the bowel is completely blocked, there is an intestinal blockage ( ileus ). In most cases, only an operation for spinal stenosis creates lasting remedy.

Fistula: Gears from the intestine to the bladder or vagina possible

When the inflammation in Crohn's disease eats deeper and deeper into the tissue, may cause transitions. Does such a transition to another loop of intestine or a hollow organ such as the bladder or the vagina, so a connection between these two areas. Doctors refer to this connection as a fistula. About these compounds can pass stool or pus into adjacent hollow organs such as bladder or vagina.
Fistulas are rejected 

Fistulae is therefore also make a stool through the vagina or the urine noticeable.Sometimes fistulas, can carry out to the body surface. Doctors try of purging of pus in the fistula drainage threads and to heal the fistula. Sometimes, however, sustained only by surgery.

Abscess: drainage as therapy 

An abscess occurs when dying cells leave pus-filled cavities. They are formed mainly in Crohn's disease in the anal region and can be very painful. The pus may be discharged through a drainage. In some cases, the abscess, however, occurs again and again, so that the doctor consider an operation.

Crohn's Disease: Symptoms

Crohn's disease often begins with general symptoms such as: 

• Flatulence
• Abdominal pain, typically lasting
• Diarrhea, often bloody and
• Fatigue, tiredness
• Fever
• Weight loss

In about every second Patient's symptoms also occur outside the digestive tract, mainly eye inflammation, joints or skin. These symptoms are probably just as Crohn's disease itself caused by a dysregulation of the immune system.

Typical are:

• Inflammation at the knees, ankles and elbows and on the joint ligaments and muscle sheaths.    Frequently, the bowel and sacral vertebrae and the joints are affected.
• Inflammation at the middle coat of the eye (uveitis) and the dermis (iritis)
• erythema nodosum, Gangrenosum a reddish nodular change on the legs and the pyoderma, a non-infectious chronic ulcer.

Can continue to occur in Crohn's disease patients, disturbances in the liver, bile ducts and other internal organs. The overall result is usually not a picture that immediately suggest a Crohn's disease.

Crohn's Disease: Diagnosis

It usually takes a while until the doctor can make the diagnosis Crohn's disease.First, he must rule out other diseases with similar symptoms. Therefore often fall longer observation periods with many studies that must bring together the doctor a mosaic. Patients should not rashly condemn their doctor if he can time of diagnosis.

The first part of the mosaic are the medical history ( history ), the exact analysis of symptoms and physical examination. It scans the doctor, for example, hardened after intestinal loops and inspected after the region to any fistula can be seen.
Gastro-intestinal endoscopy: Endoscopy is the focus

In a further step, the physician collects certain blood tests that provides information on the inflammatory activity in the body give others. Also an ultrasound scan can provide information about over thickened bowel wall, abscess or fistula supply further. The main method of examination in diseases of the digestive tract is, however, colonoscopy and gastroscopy (endoscopy). Only in this way, the physician receives direct view of the wall of the esophagus, stomach, duodenum and the colon and rectum and may remove tissue samples. There is no endoscope in a position, however, until the middle regions of the small intestine, penetrate, also supplies X-ray examination , especially the MRI Sellink an important contribution to diagnosis.

Crohn's disease diagnosis: laboratory values

The symptoms of Crohn's disease are relatively nonspecific: The patients suffer from diarrhea, abdominal pain, fever and fatigue, it also usually comes to weight loss. The doctor must first determine whether the diarrhea is not caused by bacteria such as salmonella. An examination of the stool is in the laboratory diagnosis so first.
Inflammation, and protein deficiency can be identified

Pathogens are excluded as a cause, a blood test can be revealing. This can be stated as an inflammation or a protein deficiency. Both would speak for Crohn's disease.

The following table provides an overview of key laboratory values and changes in Crohn's disease: 

Laboratory values	Sample collection	Value change in Crohn's disease	Statement
Erythrocyte sedimentation rate (ESR)	Blood	increased	Inflammation present
Leukocytes (white blood cells)	Blood	increased	Inflammation present
Hemoglobin (red blood pigment)	Blood	decreased	Blood loss, for example, bloody diarrhea, blood Education  disorders
Platelet	Blood	increased	Colon infection
C-reactive protein (CRP)	Blood	increased	Inflammation present
Albumin (serum albumin)	Blood	decreased	Protein loss through wounds in the intestines
Alpha-1 Antitrypsin	Chair	increased	Protein loss through wounds in the intestines
Schilling Test (resorption  Capacity for vitamin B12)	Urine	decreased	Recording deficits in the small intestine

A blood test is in the course of Crohn's disease therapy important: The laboratory values ​​provide information about the severity of inflammation and the success of therapy. On the basis of laboratory parameters can also be complications identified: For example, a low calcium levels in the blood indicative of osteoporosis, many E. coli bacteria in the urine indicate a fistula between the bowel and bladder out. 

A distinction between Crohn's disease and ulcerative colitis is not by blood, stool or urine examination, however, possible. They lead to almost identical changes in laboratory parameters.

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Diagnosis of ulcerative colitis - The colonoscopy is the main

The cause of ulcerative colitis is not known. The disease can be seen even from a single lesion. It is rather a mosaic of information that leads the doctor for diagnosis. For patients, this is not always easy, as the doctor often has to watch him for a long time and also a number of studies are needed. Last but not least, other diseases must be excluded similar symptoms, such as Crohn's disease.


 Describe your symptoms as accurately as possible 

The first building blocks of the mosaic form the patient's history, the nature of complaints and the physical examination. If the doctor suspects is a chronic inflammatory bowel disease, it can search for clues at this stage, by which he can distinguish ulcerative colitis from Crohn's disease.

Difference between ulcerative colitis and Crohn's disease: 

The table also shows that you are helping the doctor very much if you describe your symptoms as accurately as possible. 

A gastroscopy is not necessary 

In a further step is determined by the physician and blood tests that provides information on the inflammatory activity in the body type. The main research method is colonoscopy (colonoscopy). With the help of an endoscope thereby fattening and colon are examined. A gastroscopy (endoscopy) for the diagnosis of ulcerative colitis, however, not necessary. 

Ultrasound only in the advanced stage sense 

Also, ultrasound (sonography) is in the diagnosis of ulcerative colitis are used, but the investigation is rarely significant: It reveals, above all changes in the deeper layers of the wall and the environment of the digestive tract. These areas are in ulcerative colitis but changed only very rarely. Abnormalities occur in the ultrasound image in ulcerative colitis usually on only when the inflammation has led to a thickening of the bowel wall. 

The X-ray is in the diagnosis of ulcerative colitis today hardly any importance. Only to distinguish from Crohn's disease, the doctor may take an X-ray investigation of the small intestine.

Ulcerative colitis - colonoscopy allows accurate diagnosis

The colonoscopy (colonoscopy) is currently the safest method to diagnose ulcerative colitis. The doctor leads to a tube-like instrument (endoscope) that is equipped with an optical system including light source, through the anus into the intestine. In this way he can inspect the interior of the intestine and make using a tiny camera and photographs. A major advantage of colonoscopy: During the investigation can see the doctor about a working channel with a tiny forceps tissue samples (biopsies) of the mucosa. The picture above shows the recording of a healthy mucosa. The upper right shows the recording of the mucosa in ulcerative colitis. 

Colonoscopy: 

The doctor inspects the entire large intestine 

The colonoscopy allows an examination of the rectum (rectum), the entire large intestine (colon) and the last inch of the lower small intestine (ileum). Importance of a prior thorough colon cleansing. A sigmoidoscope (mast colonoscopy) with a rigid sigmoidoscope (15 cm long) enough to clarify the diagnosis is usually not enough. 

Patients receive a painkiller before colonoscopy 

The sigmoidoscope is not stressful for the patient. This is different for colonoscopy: The injection of air to the development of the intestinal walls and the advancement of the endoscope can be unpleasant, especially when difficult narrowing the passage. The patients received prior to the examination but a sleep like midazolam or in some cases the anesthetic propofol. Is an advancement of the endoscope impossible because of severe pain, the doctor will switch to an ultrasound or X-ray examination.

Ulcerative colitis: verify laboratory values over the treatment outcomes

Blood tests and other laboratory parameters in almost all diseases very meaningful. Even with the diagnosis of ulcerative colitis, they play a role: They provide information about the severity of inflammation and the success of therapy.A distinction between ulcerative colitis and Crohn's disease , however, is not reliably possible. 

The most important laboratory parameter for ulcerative colitis are: 

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Ulcerative colitis - complications megacolon and intestinal perforation

A very rare but life-threatening complication of ulcerative colitis is toxic megacolon, a massive expansion of the large intestine, which is associated with severe bloating and severe pain. By the damaged intestinal wall enter bacteria and toxic constituents of the chyme into the blood and lead to blood poisoning (sepsis).Therefore, then stir more typical symptoms such as fever, chills, and palpitations.


Megacolon: Often Medications Help


Case of a suspected megacolon, the doctor will order an X-ray of the abdomen. In this way, the intestine rapidly detect enlargement. Confirmed the diagnosis, the colon needs to be relieved quickly. This is usually done by an aggressive medical therapy, for example, with high-dose corticosteroids or tacrolimus . Shows this not, one is colectomy necessary: The surgeon removes the large intestine - if possible with sparing of the rectum and anus. He leads the small intestine, at least temporarily, on the abdominal wall using a colostomy (stoma) from. Once the patient has recovered, the surgeon tries, the voluntary control of defecation on a connection between the small intestine and after restore.


Emergency Surgery for Intestinal Perforation


In a toxic megacolon - but also for other reasons - there may be an opening (perforation). The tract then flows directly into the abdominal cavity and then calls in a short time produced a dangerous peritonitis. The life of the patient must then be saved only by immediate emergency surgery.
Other complications
Other complications of ulcerative colitis, blood loss through the intestines, and - very rarely - scars and bottlenecks in the intestine (strictures). Finally, it is also risk of colorectal cancer in ulcerative colitis patients increases.

Symptoms: Ulcerative Colitis

The most prominent symptom in ulcerative colitis is a bloody, mucous stools, some with up to 15 movements per day. There are also a pain, but they are mostly limited to the period before and after defecation. Other symptoms include weight loss, fatigue, weakness and sometimes fever.

Ulcerative colitis can also be felt in other organs than the intestine. Doctors refer to this case of extra-intestinal manifestations . Possible symptoms include the eyes, joints and skin.
Fistulas and abscesses speak against ulcerative colitis
In contrast to Crohn's disease intestine is in ulcerative colitis only one affected, also inflammation is limited to the mucosa (mucosa) limited to deeper layers of the wall are not affected. pus (abscesses) and transitions into the adjacent tissue (fistulas ) are therefore extremely rare and speak against ulcerative colitis and Crohn's disease for more.

Caution in Severe Abdominal Pain and High Fever

In severe cases it can in very rare cases life-threatening complications occur. This includes in particular the intestinal perforation (perforation) and a massive expansion of the gut, the toxic megacolon. The complications associated with severe abdominal pain, a significantly increased heart rate (tachycardia) and high fever and often leads to shock. When a perforation sustained only by emergency surgery to save the life of the patient. In the case of megacolon can often provide a drug therapy problem.

Typical Symptoms of Ulcerative Colitis are Summarized:

• severe muco-bloody diarrhea
• Pain, usually only before and after defecation (tenesmus)
• Fever
• Weight loss
• Discomfort in the joints, eyes, liver and skin.

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Ulcerative colitis (chronic inflammation of the intestine

Ulcerative colitis is a disease that strikes primarily young people. In most patients, this chronic inflammation occurs in the colon for the first time aged 20 and 30.Typical symptoms of ulcerative colitis are severe, some mucous-bloody diarrhea, abdominal pain, weight loss and general malaise.
Ulcerative colitis, Crohn's disease is less dramatic than Ulcerative colitis is relatively widespread: an estimated 150,000 people in Germany are concerned, about as many as from Crohn's disease , also a chronic inflammatory bowel disease (IBD). Crohn's disease and ulcerative colitis have a lot of similarity with each other. However, ulcerative colitis, the disease is less dramatic: it does not spread throughout the digestive tract, but typically begins in the rectum and extends up to the small bowel end. In addition, the inflammation remains confined to the mucosa and spared the deeper layers of the wall.

Favorable prognosis 

Ulcerative colitis typically runs in waves, periods of increased disease activity alternate with symptom-free intervals. With today's drugs can usually control the disease well, only in exceptional cases, it is necessary to remove large intestine .The prognosis for many patients, so rather cheap. This is especially true when only the lower parts of the colon are affected.

Risk Factors

What ulcerative colitis ultimately caused is still unknown. Doctors suspect that this is an impaired immune response to bacterial antigens. Another component of the disease appears to be the genetic predisposition.


No Question of Food 

In some counselors say, ulcerative colitis arises through nutrition. This assumption is not scientifically proved. There is only evidence that individual to the needs of the patient's diet positively affect the disease process adapted.

Mental Health Problems do not Matter 

Also, the previously discussed psychological causes of the disease are now excluded. However, the psychological well-being and stress management of the patient undoubtedly has an influence on the course of the disease. Today the focus is on the common fears associated with the disease or depression , psychotherapy in the handle to get psychologically.

In Ulcerative Colitis Comorbidities

Patients with ulcerative colitis often suffer from concomitant diseases that are associated with bowel disease. They are probably just as ulcerative colitis itself caused by a dysregulation of the immune system. There are mainly diseases of the musculoskeletal system, eyes and the skin:

• Musculoskeletal system: arthritis is typical, more precisely, inflammation of the knee, hock and elbow joints as well as the ligaments and muscle sheaths.Frequently, the sacroiliac joint or facet joints are affected.

• Eyes: The focus is inflammation at the middle coat of the eye (uveitis) and the sclera (scleritis).

• Skin: Typical skin manifestations are erythema nodosum, a red-nodular changes on the legs, rarely does the pyoderma gangrenosum before, a non-infectious ulcer.

May also occur in ulcerative colitis patients and disorders of the liver, bile ducts and other internal organs. Doctors refer to these cases in which misdirected immune response in ulcerative colitis, the other organs also show extraintestinal manifestations.

Ulcerative Colitis can Cause Osteoporosis

An immediate consequence of ulcerative colitis may be a decreased bone density, as osteopenia, or - if it is already strong - as osteoporosis ) is called brittle bones (.The bones lose stability in advanced stages and can break even the smallest bumps. Well over 15 percent of ulcerative colitis patients are affected by osteopenia or osteoporosis. Possible causes are:

• the diarrhea, go through the many nutrients lost virgin

• the poor nutrient absorption through the gut

• the bone-depleting effect of the inflammation itself

• a prolonged treatment with cortisone.

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Diarrhea: Many causes are;

Most often by cases occur due to infections with pathogens such as bacteria or viruses. But many other causes are, if you suffer from diarrhea:










Possible Causes of Diarrhea:

• Anxiety, stress and anxiety, many people respond with excitement as before an exam or a presentation with diarrhea. Also, fear , such as before a flight , or stress in the family or at work can upset the gut.

• Certain medications: antibiotics , antacids, diuretics, cytostatics, and means for weight loss can cause diarrhea. Many antibiotics disrupt the normal bacterial colonization in the intestine. The intestinal symptoms sound but usually after the end of antibiotic treatment. In addition, diarrhea often occurs during chemotherapy because the cytotoxic attack the sensitive cells in the intestinal mucosa. In these cases, you should consult with your doctor.

• Coli: They cause diarrhea mostly in the summer, when tainted food or contaminated drinking water are consumed.

• Food poisoning: Tainted food can cause severe diarrhea. Cause are usually toxins from bacteria. The first symptoms occur within six hours after consumption. Other symptoms such as vomiting, nausea and cramps can be added. Pay for food on the expiry date and cook meat and fish in doubt, good.

• Parasites: Parasites such as worms or single-celled organisms (protozoa) can also cause diarrhea. The amoebic dysentery example, is a protozoal, which is associated with watery or bloody diarrhea and fever.

• Travelers' diarrhea: diarrhea while traveling can have different triggers. You can protect yourself by only drinks from industrially-filled bottles and cans eat. Do it without any ice. You should eat only cooked or fried food and (even) peeled fruit.Do not use salad and ice cream. Also, the consumption of small amounts reduces the risk of disease, because the stomach acid is less diluted and thus better able to kill germs.

• Irritable bowel syndrome: an irritable bowel or intestine is a nervous symptoms such as diarrhea, flatulence, bloating, abdominal cramps and constipation associated with. The symptoms occur in alternation, with no specific cause is known.

• Inflammatory bowel disease: the case of chronic intestinal inflammation such as ulcerative colitis and Crohn's disease, diarrhea is a major symptom.

• Typhoid, paratyphoid, cholera -, dysentery organisms: In Europe, such infections usually not available. They are often introduced by long-distance travel. Triggers are certain bacteria in all four diseases. The agent for typhoidand paratyphoid belong to the family of Salmonella.

• Excessive alcohol consumption

• Excessive eating of dietary sugars such as sorbitol or mannitol: We find this sweetener in sugarless chewing gum and other sugar-free candies.

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Clostridia: Hazardous diarrhea after antibiotic therapy

In addition to the common norovirus or salmonella infections is another pathogen that causes severe diarrhea regularly: the clostridia. The strong intestinal germ multiplies rapidly always particularly when the normal intestinal flora is weakened by antibiotics. Gastrointestinal symptoms during antibiotic therapy are not uncommon, but they go over most if the drug is not taken. A clostridial diarrhea other hand, can still occur several weeks after the end of antibiotics.








Clostridial toxins attack the intestinal mucosa
If during treatment with antibiotics for severe diarrhea, is near always the suspicion that clostridia are involved. Their toxins attack the intestinal mucosa and lead to severe inflammation.Stool examination in the laboratory brings clarity.A strong, ending after the end of the antibiotics unending diarrhea is always a serious warning. To do so promptly to the doctor. A laboratory examination of stool tells you whether the symptoms actually causeclostridial.Clostridia must be addressed specifically.Clostridia were detected as a cause of diarrhea, immediately, other antibiotics are used which have a reliable from the dangerous bacteria. Sometimes the diarrhea treatment time will be extended to other than the original disease treated with antibiotics.

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Campylobacter infection: diarrhea caused by chicken meat and raw milk

Many summer diarrhea at the hands of a dangerous bacterium called Campylobacter. In addition to salmonella campylobacter are the most common cause of summer gastro-intestinal flu. Especially children under age six suffer on Campylobacter diarrhea, but is caught by young adults between 20 and 30 years it often.









Beware of Campylobacter in chicken meat from the grill
Salmonella and Campylobacter are both incorporated by food or drinking water in the body. But unlike salmonella, campylobacter bacteria cannot multiply on food. Nevertheless, the virus is tricky: it is massively present in poultry feed plants and multiplies there very quickly when spring ends and summer comes. Then is well known, barbecue season and crispy chicken is often a hit on barbecues. If the chicken thighs but not thoroughly cooked, the guests will be hard to keep bad memories because a few days later, worse diarrhea (diarrhea) plagues. But chicken is not the only source of infection, including raw milk, right on the farm bought and consumed uncooked, may lead to Campylobacter diarrhea.
"Duck breast" means a dangerous pleasure
Besides barbecue chicken and raw milk can also benefit from a duck breast, are dangerous. For gourmets, is particularly popular "duck breast". Here, the duck meat is not cooked through, so it is not tough. But that can be fatal to the gourmet, because only at cooking temperatures above 74 ° C, the Campylobacter bacteria are killed reliable.
Campylobacter diarrhea in severe immune deficiency
Fortunately not, anyone who has "swallowed" some Campylobacter, a diarrheal disease. Many infections are completely unnoticed, sometimes the symptoms are only very weak. However, a large number of bacteria included infectious or immunocompromised persons, the disease is often accompanied by fever, muscle and joint pain, severe diarrhea and severe malaise.
Important: fluid and mineral salts must be replaced
A targeted antibiotic therapy is only necessary if the body is ready not only with the germs. Usually triggered by Campylobacter gastro-intestinal flu for at least a week is over. Is important, however, as with all other diarrheal diseases, the body with enough fluids and mineral salts is supplied.

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