Talk:Ulcerative colitis

Omega-3 fatty acids contribute to digestive system health. You haven't figured out why 5-ASA are, but NSAIDs are not, used therapeutically (yet the target inflamation)? Same reason NSAIDs promote stomach ulcers, they inhibit prostaglandins that are protective of the stomach lining as well as the rest of digestive system lining. Long term high dose use has been implicated in promoting IBD. Shjacks45 (talk) 10:56, 1 May 2014 (UTC)

And your reference for your statement (title and page number) is what, exactly? HammerFilmFan (talk) 16:50, 3 June 2015 (UTC)

×==Bacterial recolonisation part==

This part has problems, the fecal recolonisation part. I removed sentence, as it is PPOV and suggesting self medication "In the United States it can be difficult to find doctors who perform this procedure so some patients have performed the procedure at home using a protocol outlined in a published study." And the protocol is included, so, we have here "try it at home situation." First, doctors don't perform it as is it not approved treatment, not even far in development. Second, there were only tiny samples in experiments: 6 people, 10 children, and results were mixed. Third; so far results are mixed.In one study there was 67% remission, in other one was only 32% response (a little bit bellow placebo effect). Fourth: There are not even larger double blind studies,so, it can't be said it is even a method in development, more like case studies than a full blown research. Fecal recolonisation was tried in small samples on patients with various illnesses, among them patients autoimmune diseases, including UC andCrohn's dissease..Even autism was included in trials, and so far doesn't look that his method is very promising, according to paper from 2014, about this treatment and UC.I don't even know why this part (fecal recolonisation) is included in the body of the article, as there are not numerous studies like is the case with probiotics, but only so few with so tiny samples. Case studies abound in medicine, and if we were to include them in wikipedia articles, we could have very long articles.Why not to focus on larger, double blind studies, they are more advanced. I would say this part fits more into diarrhea section, as three are more studies regarding this treatment in various types of diarrhea, and those were very succesful. ^[1] As you see from this source, fecal bacterial transplant was used as support in probiotic recolonisation, quoting the article "The intestinal ecosystem of each individual patient reacted very differently to the fecal transplantation. Intestinal bacteria of the donors were detected in the patients, but at different times and in different frequencies." Bialosz (talk) 11:32, 31 January 2016 (UTC)

The upshot of the current text is that hydrogen sulfide is detrimental. Both articles cited are over 15 years old. Newer references exist that reverse the detrimental view of H2S. Furthermore, a role in future therapeutics is being investigated. I propose updating this section. Any thoughts among the watchers of UC? Thanks in advance for your input. ^{[1] [2]}

McortNGHH (talk) 20:27, 15 April 2016 (UTC)

19:41, 24 June 2016 (UTC)Jay Pravda MD MPH (talk)The evidence suggests that colonic inflammation in ulcerative colitis develops as a result of excess colonic epithelial hydrogen peroxide that diffuses (leaks) out of epithelial cells and oxidizes (damages) tight junctional proteins. This increases mucosal permeability to luminal bacterial antigens that gain access to the normally sterile submucosal tissues, which initiates a neutrophilic inflammation characteristic of this disease (1).

There is sufficient experimental data to substantiate further studies to verify if this mechanism of disease is indeed operative in ulcerative colitis (2, 3). I strongly encourage research institutions that have an interest in curing ulcerative colitis to fund the necessary studies in order to determine if this mechanism of disease is indeed the cause of ulcerative colitis.

The sooner we know the truth, the closer we get to the cure.

1. Radical induction theory of ulcerative colitis http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4305621/

2. Impairment of mitochondrial acetoacetyl CoA thiolase activity in the colonic mucosa of patients with ulcerative colitis http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2095666/

3. Differential immune and genetic responses in rat models of Crohn's colitis and ulcerative colitis http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025515/

Jay Pravda MD MPH

doi:10.1016/S0140-6736(16)32126-2 JFW | T@lk 09:29, 2 December 2016 (UTC)

This edit from an ip (Removed frequency and deaths as they give info for Chron's disease which is NOT ulcerative colitis - therefore irrelevant) was reverted . I agree with the ip.

The same has happened with the Crohn's disease page .

In my opinion, it is very confusing. Keep in mind that it is intended for the general public, of all intellectual levels. What does the reader have to understand? That these are deaths and frequency of people who have both ulcerative colitis and Crohn's disease? Or that are people who only have Crohn's disease? And where...?

I would leave these figures only on the IBD page. Here it is not informative, just the opposite. If we do not have specific figures, we do not have specific figures.

As I have said more times, attempts to simplify sometimes confuse rather than help. And that is worrisome. --BallenaBlanca 🐳 ♂ (Talk) 10:06, 4 April 2018 (UTC)

This is not data just for Crohn's disease but data for CD and UC together. IMO they are useful both here and the IBD page. If we have data for just CD by itself than sure. Doc James (talk · contribs · email) 19:24, 4 April 2018 (UTC)

Do we apply the same criteria here as in Crohn's disease? --BallenaBlanca 🐳 ♂ (Talk) 23:13, 5 April 2018 (UTC)

In addition, the figure is wrong, not 112 million but 11.2 million (see table 2 "11 223·5 thousands". --BallenaBlanca 🐳 ♂ (Talk) 23:27, 5 April 2018 (UTC)

Yes agree the figure is wrong and fixed it. Do you have figures for just UC? Doc James (talk · contribs · email) 16:31, 7 April 2018 (UTC)

Can someone give a precise citation for this figure (page or table number)? SarahSV ^(talk) 17:49, 7 April 2018 (UTC)

@Doc James: I do not understand why you have reinserted this data . It is very confusing and readers do not understand it. I will not repeat what I said above , but please, can you re-evaluate it putting yourself in the mind of a lay person who does not know what inflammatory bowel disease is, or what diseases it covers, why is Crohn's disease mentioned here ...?

I already added the data in inflammatory bowel disease and fixed the incorrect figure and IMO that is enough. --BallenaBlanca 🐳 ♂ (Talk) 18:20, 7 April 2018 (UTC)

Because this is the data we have. If you have data for UC by itself we can use it. Doc James (talk · contribs · email) 18:23, 7 April 2018 (UTC)

This Lancet paper PMID:22001864, page 1488, is unclear and needs explanation -- not easy in the Infobox. I suggest we drop the global combined IBD figure (very much an estimate) from the UC article and see if we can find another ref.Jrfw51 (talk) 18:28, 7 April 2018 (UTC)

This one PMID 29050646 "Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies" (Lancet, December 2018) contains separate data with graphics and tables. I can send you the pdf --BallenaBlanca 🐳 ♂ (Talk) 18:40, 7 April 2018 (UTC)

That looks to be good for prevalence but global mortality data are not very relevant as SMR are only slightly increased and variable. PMID:25185685 Overall UC Highest risk estimate. HR, 1.25 (95% CI, 1.22–1.28); Lowest estimate, Pooled SMR, 1.1 (95% CI, 0.9–1.2). Jrfw51 (talk) 18:55, 7 April 2018 (UTC)

Which details about UC are you thinking we should use? Doc James (talk · contribs · email) 09:08, 8 April 2018 (UTC)

I would drop the Deaths data from the Infobox. Jrfw51 (talk) 10:17, 8 April 2018 (UTC)

Do we have details on the death rate for UC alone? Doc James (talk · contribs · email) 06:36, 9 April 2018 (UTC)

Can this be useful? PMID 25071340 Epidemiology, demographic characteristics and prognostic predictors of ulcerative colitis: "In meta-analyses of population-based cohort studies reported by Jess et al, five of 10 studies reported on UC-related mortality. The authors reported that among patients with UC, the mean percentage of deaths ascribed to UC itself was 17% (range 11% to 30%)." --BallenaBlanca 🐳 ♂ (Talk) 22:50, 10 April 2018 (UTC)

Can have an ulcerative affect on the colon wall according to some sources Wikipietime (talk) 18:05, 17 June 2018 (UTC)

Having an ulcerative effect on the colonic mucosa is very different than ulcerative colitis. Many factors can lead to ulcers in the colon (lack of blood flow, constipation, etc), which have nothing to do with ulcerative colitis. However, if there is good quality evidence that lectin may contribute to the development of ulcerative colitis, I encourage you to add this content to the article, with references. Rytyho usa (talk) 01:49, 23 October 2020 (UTC)

The article says "Dietary changes, such as maintaining a high-calorie diet or lactose-free diet, may improve symptoms.", but the reference doesn't seem to support this. Rather a linked page from the reference says "Ulcerative colitis symptoms may cause some people to lose their appetite and eat less, and they may not get enough nutrients.". While it may be true that a lactose-free diet (with appropriate supplementation) may reduce symptoms, aggravation, or onset of the condition (probably through microbiome related complex dynamics), it seems that the claim of a high calorie diet being helpful isn't backed obviously by the reference. The claim about dairy should probably be refined, but right now I suggest that the claim about high-calorie diet be dropped or be refined or qualified with peer reviewed research / a more obvious reliable source. — Preceding unsigned comment added by Thefreeencyclopedia1 (talk • contribs) 15:57, 12 February 2021 (UTC)

I just read the source and couldn’t find a reference to either the dairy part or the high calories. 78.152.205.15 (talk) 07:28, 23 July 2023 (UTC)

This article was the subject of a Wiki Education Foundation-supported course assignment, between 24 October 2022 and 18 November 2022. Further details are available on the course page. Student editor(s): Rasika ucf (article contribs). Peer reviewers: Medabloom.

— Assignment last updated by DrDexterN (talk) 20:17, 14 November 2022 (UTC)

Hello, I am a fourth-year medical student from the University of Central Florida, and I am enrolled in a WikiProject course. I have chosen this article and plan to edit it by changing wording and structure of some sentences that may be misleading or may use medical jargon. I plan to explain the meaning of various terms that would not be well known to most viewers (ex. Skip lesions, ileus, biologics etc.). The article seems to have most citations in place, but there are a few areas that indicate a need for citations. I hope to add references for those areas.

I also hope to add more information in the “Differential diagnosis” section of the article, as many of the diagnoses listed include vague descriptions. Additionally, I will update the information regarding medications and their side effects.

I would be happy to take any suggestions for changes as well! Rasika ucf (talk) 00:01, 8 November 2022 (UTC)

I learned so much from reading this article, especially from your contributions. Overall, I think your contributions were relevant, concise (which is not easy to do), important, and necessary additions to the article. From reading through your work plan, you achieved everything you hoped to accomplish. The information added is also understandable to the intended WP audience.

Great job editing and changing the wording and structure of sentences that were misleading or used medical jargon. A specific example of this was when you concisely defined “systemic signs of toxicity,” as “fever, chills, weight changes.” Contributions such as these are important for the understanding of the average reader.

I found it helpful that you explained the meaning of various terms that would not be well-known to most viewers, such as toxic megacolon.  

I appreciate how many references you contributed to the article (13!). I think your inclusion of quality secondary sources really takes this article to the next level, especially for viewers who may be interested in further reading on the topic.

I enjoyed reading and learning from your additions on primary sclerosing cholangitis, pyoderma gangrenosum, anemia, and hidradenitis suppurativa - it was well-done, concise, and packed with an informative punch accessible to the layperson! Your large addition to the imaging section really improved that portion of the article, which was very trim before.

You went above and beyond to meet your goal of expanding the differential diagnoses section. Thank you for explaining how to distinguish Crohn's disease, infectious colitis, other forms of colitis, and graft versus host disease from ulcerative colitis.

I spot-checked the links and they are all working! The article flows understandably and meets readability guidelines (no sentences longer than 26 words). You made use of periods and few commas or semicolons.

A suggestion for improvement could include adding more of the wiki links to different terms in the article such as: anal fissures, abscess, and infectious colitis.

Medabloom (talk) 18:59, 17 November 2022 (UTC)

Thank you so much for your feedback! I really appreciate your help and will definitely try to incorporate some more wikilinks! Rasika ucf (talk) 14:03, 18 November 2022 (UTC)

As the title states, the Mayo Endoscopic Score should be mentioned somewhere in the article. Either under the Endoscopic subheading under the Diagnosis section and/or under the Progression/Remission subheading under the Prognosis section. After all MES is the common endoscopic index recommended in guidelines and considered a quality indicator, and widely used in clinical trials and clinical practice. Instantwatym (talk) 18:26, 10 September 2023 (UTC)