Paper Example: Immune System Disorder: Ulcerative Colitis

The immune system of an individual plays a key role in fighting against infections and other complex body invaders. Without a strong immune system, bacteria and viruses could negatively impact the body. There is a possibility that a person’s immune system could be characterized by adverse outcomes. For example, a person could be born with a weak immune system. Alternatively, diseases could weaken one’s immune capacity. Moreover, there are cases where the immune system could turn against a person’s body, which leads to autoimmune diseases. Furthermore, the immune system could be too active. In this case, there is a group of diseases or conditions that are classified as immune system disorders. One of the immune system disorders is called Ulcerative Colitis. This excerpt provides an overview of Ulcerative Colitis based on a case interview with Jane (not her real name) as one of the immune system disorders.

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Ulcerative Colitis is an inflammatory disease that affects the bowel system. It is a frequent diagnosis among young adults. Jane is among the high number of young adults between the age of 30 and 40 who have been diagnosed with the condition. Ulcerative Colitis is rapidly increasing in America, Asia, parts of Europe, and Africa (Zhou et al., 2020).

Since Ulcerative Colitis is an idiopathic inflammatory condition, there is a high chance of disability. The disorder starts from the rectum and extends to the other proximal section of the colon (Ungaro et al., 2017). Since Jane is suffering from Ulcerative Colitis, it implies that her bowel is occasionally exhibiting mucosal inflammation. The severity and progressiveness of Ulcerative Colitis are categorized as mild to moderate or as moderate to severe.

According to the interview, Jane was already at the severe stage of the condition. Patients such as Jane who are diagnosed with this condition begin to exhibit four to five bowel movements per day; however, this changes with the level of degeneration where adverse symptoms and complications emerge. At a severe stage, Ulcerative Colitis patients experience extreme inflammatory burden, advanced constitutional symptoms, and increased bowel movement (Ungaro et al., 2017).

Jane, who is a 28-year old African-American was diagnosed with Ulcerative Colitis at the age of 21. In this case, has been suffering from the condition for the past seven years. Long-term illness harms the life of the patient, which implies that people diagnosed with Ulcerative Colitis face significant challenges at work and at home. Studies indicate that the challenges originate from extreme inflammation of the bowel region (Ungaro et al., 2017; Zhou et al., 2020).

According to Jane, her illness has negatively impacted her career path. As a social worker, her duties involved field supervisions and community engagement; however, since her deterioration, she has been unable to undertake her duties effectively. Most of her roles have been scaled down to paperwork back in the office. She goes to work two hours late after the normal reporting time and leaves the workplace earlier than her fellow employees. While this arrangement was reached by negotiation with her boss, her productivity has drastically reduced over the years.

Another remarkable change in her life is the way she interacts with her family. Jane ascertains that she never goes out to family events and outings as she used to do before her condition worsened. Additionally, she cannot undertake extraneous house chores such as laundry, shopping, taking her kids to school, and yardwork. Patients living with Ulcerative Colitis have challenges because of the impacts of the condition on bowel movement (Ko et al., 2019; Ungaro et al., 2017).

Ulcerative Colitis has several negative effects on the body. The disorder occurs in a different part of the lower end of the gut and depending on the affected region, the patient could exhibit different challenges. When the entire colon is affected, it leads to severe diarrhea with excess blood. Bowel movements are accompanied by severe pain. The patient could exhibit a major reduction in body weight and frequent fatigue due to severe diarrhea. Fever and belly cramps are also common. Jane noted that bloody severe diarrhea is one of her common experiences. She also stated that she occasionally experiences fatigue and belly cramps, which impacts her ability to execute daily duties.

Additionally, Jane argued that the disease is equally associated with emotional impacts. She pointed out that the pain, fatigue, and frequent bowel movement is traumatizing and generate emotional distress. The inability to meet personal goals is depressing. Lack of adequate social relationships also exacerbates a person’s wellbeing. Clinical evidence indicates a significant relationship between Ulcerative Colitis and depressive symptoms (Ananthakrishnan et al., 2013).

The most common methods of treatment are Aminosalicylates for moderate and mild stages while immunosuppressants are used at moderate and severe stages. On the other hand, over 15% of patients require colectomy (Ungaro et al., 2017). Jane’s current treatment therapies include a regular dose of 6-mercaptopurine, which is a Thiopurine. Thiopurines are recommended for patients with moderate to severe Ulcerative Colitis (Ungaro et al., 2017). Thiopurines could be combined with biological drugs. Additionally, clinical practice guidelines have ascertained that anti-TNF-a drugs such as golimumab, infliximab, or adalimumab could be used to induce and maintain the process of remission. Studies on the effects of these drugs are limited and characterized by inconsistencies; however, new alternatives have emerged (Ungaro et al., 2017). A new line of medications has shown positive results for patients, which implies that individuals like Jane could experience effective symptom management. The use of biological drugs with anti-adhesive molecular inhibitors have shown a high level of resilience to the a-4B7 integrin (Ungaro et al., 2017).

In conclusion, Ulcerative Colitis is a long-term condition that is associated with adverse effects. The cause of the disorder is extreme bowel inflammation. While the disease occurs in mild to moderate form, some patients should be diagnosed with moderate to severe levels of Ulcerative Colitis. The most common methods of treatment are Aminosalicylates for moderate and mild stages while immunosuppressants are used at moderate and severe stages. On the other hand, over 15% of patients require colectomy. Jane has been living with the condition for the past seven years. She has experienced significant challenges that relate to her work and at home. She has witnessed changes in her social life that have contributed to her emotional toll. However, by working closely with her doctor, she has managed to create a schedule that enhances her coping capabilities. Work arrangements with her supervisor have seen Jane shifting from fieldwork to office-based paperwork, which is manageable. While there are different alternative treatment therapies for Jane, her current medication is working effectively for her condition.

References

Ananthakrishnan, A. N., Gainer, V. S., Cai, T., Perez, R. G., Cheng, S. C., Savova, G., Chen, P., Szolovits, P., Xia, Z., De Jager, P. L., Shaw, S., Churchill, S., Karlson, E. W., Kohane, I., Perlis, R. H., Plenge, R. M., Murphy, S. N., & Liao, K. P. (2013). Similar risks of depression and anxiety following surgery or hospitalization for Crohn's disease and ulcerative colitis. The American journal of gastroenterology, 108(4), 594–601. DOI: 10.1038/ajg.2012.471

Ko, C. W., Singh, S., Feuerstein, J. D., Falck-Ytter, C., Falck-Ytter, Y., Cross, R. K., & American Gastroenterological Association Institute Clinical Guidelines Committee (2019). AGA Clinical Practice Guidelines on the Management of Mild-to-Moderate Ulcerative Colitis. Gastroenterology, 156(3), 748–764. DOI: 10.1053/j.gastro.2018.12.009

Ungaro, R., Mehandru, S., Allen, P. B., Peyrin-Biroulet, L., & Colombel, J. F. (2017). Ulcerative colitis. Lancet (London, England), 389(10080), 1756–1770. DOI: 10.1016/S0140-6736(16)32126-2

Zhou, T., Pan, J., Lai, B., Cen, L., Jiang, W., Yu, C., & Shen, Z. (2020). Bone mineral density is negatively correlated with ulcerative colitis: A systematic review and meta-analysis. Clinical and translational medicine, 9(1), 18. DOI: 10.1186/s40169-020-00270-0