What Is Fulminating Ulcerative Colitis?

Ulcerative colitis is a form of inflammatory bowel disease. It is an auto-immune condition, which means that the body's immune system becomes abnormally activated and, as a result, starts to attack healthy tissue. Ulcerative colitis initially leads to bloody diarrhea, but it can progress to a more severe disease which can cause the intestine to rupture. It can also have symptoms that affect areas of the body outside of the colon.

Identification

• Fulminant ulcerative colitis is a very severe form of ulcerative colitis. In this case the inflammation of the colon goes beyond the mucosa (the inner lining) and has spread to some of the supportive tissue. If untreated, the colon can rupture.

Symptoms

• Fulminating ulcerative colitis causes constant rectal bleeding and more than ten bowel movements per day. It can also make the abdomen very painful and ultimately require blood transfusions. If colonic rupture occurs, it can cause widespread infection and death.

Non-Intentestinal Symptoms

• Fulminant ulcerative colitis can also lead to other symptoms. People suffering from fulminating ulcerative colitis may experience ulcers in the mouth, inflammation of the iris, and other inflamed tissues. In some cases the patient will develop arthritis or large skin lesions. They are also at risk for blood clots, anemia and having the ends of their fingers swell.

Treatment

• Patients with fulminating ulcerative colitis will need to be hospitalized immediately. The patient will initially be given intravenous corticosteroids, such as hydrocortisone or prednisolone, as part of a continuous infusion. If they are not responding well to treatment, they should receive hydrocortisone enemas and intravenous antibiotics.

Surgery

• For patients who do not respond well to treatment, the best option may be surgery. Ulcerative colitis is unique in that surgical removal of the colon will completely cure the disease. When the colon is removed, a portion of the small intestine will either be moved down to connect with the anus, or to an area in the abdominal wall where it can be drained with an ileostomy bag.