Q: I am a 23 year old male. Few days back I was treated by my family doctor with Coligon O, Satrogyl and Razo 20 for diarrhoea, mild fever, cramps in my lower abdomen, and an urgency to pass stool. Stools contained no visible blood but were watery, soily and had large amounts of mucus. I am having the same problem for past 4 years now and it occurs with a gap of 4 to 5 months and the problem has got aggravated. Now I have stopped taking the medicines, but still sometimes get pain in lower abdomen resulting in a watery, soily and mucus (and very rarely small amounts of visible blood) filled stool. I have observed that I face these problems when I get tense and stressed. Does this indicate that I have ulcerative colitis (UC)? If yes, is it severe? Do I need to take further medications or consult a gastroentrologist locally? A lot has been written on the Internet about nicotine preventing these UC remissions, is it true?

A:From your symptoms, I form the impression that your bowel problem is very likely to be due to ulcerative colitis, but it is important for you get your stools checked for infections like dysentery and amebiasis, which can be treated and cured. If your stools are negative you need to consult a gastroenterologist for barium Xray studies as well as colonoscopy and biopsies to confirm ulcerative colitis. Ulcerative colitis can affect just the last part of the colon or can involve the colon to variable lengths, but in most people it tends to affect the left side. It is a recurring problem which means that you need active treatment when there is acute diarrhoea and bleeding and when the symptoms settle you need to be on long term maintenance treatment to prevent further relapses. Your question about nicotine is interesting as I was actively involved in the initial research nicotine in ulcerative colitis and it has some beneficial effects. However I would not advice anyone to use nicotine as the first line of drug for the disorder as there are other more specific drugs well researched into.