Page 118 - EJMO-9-2

Eurasian Journal of
Medicine and Oncology Understanding ulcerative colitis

wall, often accompanied by bleeding. Endoscopically, individuals with UC. UC patients often report fatigue,
3,4
mild-to-moderate UC is defined as mucosal erythema, sleep disturbances, unable to perform daily activities,
decreased or absent vascularization, friability, and erosions. and feelings of inadequacy in completing their daily
5
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In the United States of America, more than a quarter- chores, or taking part in leisure activities. Many patients
million people suffer from this condition. Although the worry about surgery and the potential risk of developing
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specific cause of IBD is not known, scientists suggest that cancer. Several studies collectively support the idea
genetics, family history, and independent risk factors play a that heightened stress perception increases the risk for
major role. Clinical and demographic elements are crucial symptom relapse. 23-26 Even during remission, overall well-
in assessing disease progression and patient management. being remains affected, as individuals with UC experience
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The goal of treatment is to achieve disease remission, poor general health, indicating a major burden of disease
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prevent disease-related complications such as infection, and persistent negative symptoms. Thus, not only
surgery, and neoplasia, as well as preserve patients’ quality physical health but also psychological, emotional, and
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of life (QOL). In addition, the aim of treatment is to achieve social aspects of daily life are affected. Few studies were
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endoscopic and histological remission. 9 found on QOL during severe exacerbations and following
surgery. 28-30 Many studies focused on stress, anxiety, and
Studies indicate that patients with UC often experience depression. 24-26 Studies have shown that stress triggers the
psychological issues, which can significantly impact their release of cytokines, which activate the immune system
recovery and response to treatment. These issues may and lead to inflammation. The brain-gut axis interaction
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stem from dietary changes, medication effects, healthcare has also been studied extensively. The brain-gut axis
experiences, depression, and anxiety due to improper is a complicated, bidirectional system that includes
functioning of the body. Thus, it becomes critical to numerous connections between the gastrointestinal
understand the behavioral underpinnings of patient’s tract, autonomic nervous system, and neuroendocrine
health, leading to poor QOL and to what extent patients pathways. Research shows that brain-gut interactions
feel they have control over their disease. The concept of affect psychological well-being and symptom reporting
locus of control (LOC) refers to the degree to which an in functional gastrointestinal disorders. Anxiety or
individual believes their actions influence life events. depression has been associated with the development of
Those who believe they have control over outcomes exhibit new-onset gastrointestinal symptoms, while the presence
an internal LOC, whereas those who attribute control to of gastrointestinal symptoms has been associated with the
external factors have an external LOC. UC has phases of de novo development of psychological disorders. There
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relapse and remission. According to Goddard, relapse are insufficient data to determine whether psychological
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rates are high for many forms of psychopathology, placing disorders are caused by disease activity or factors that
significant emotional tolls on both patients and their contribute to the occurrence of IBD. Furthermore, the
families. Thus, it is important to identify high-risk patients precise mechanisms by which depression, anxiety, and
for relapse after remission. A greater understanding of the cognitive dysfunction may manifest in these patients
risk factors helps in the development of more effective remain unclear. Commonly, both UC and Chron’s disease
interventions. One important psychological factor follow a pattern of exacerbations and remissions. Studies
influencing relapse is expressed emotion (EE). Research suggest that between 25% and 50% of patients experience
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indicates that psychological variables not only affect the a relapse within 1 year. Hence, the study of QOL, LOC,
structure and function of the brain but also influence the and EE in individuals with UC may provide an insight
timing of gene expression. 14,15 Empirical data show that EE for developing psychotherapeutic treatment modalities
is one of the important psychological stressors that show aimed at reducing disease symptoms and restoring mental
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a direct association with the recurrence of the illness. health.
Studies show that LOC and EE are significantly associated,
particularly with an internal LOC. Individuals with a high 2. Materials and methods
internal LOC believe that they are accountable for the 2.1. Materials
results of their actions and, as a result, perceive greater
control over reinforcements. 17 The Multidimensional Health LOC scales were used
to assess individuals’ perceptions of control over their
Literature related to QOL, LOC, and EE have been health outcomes. The widely utilized Forms A and B were
explored in many different psychological issues but not initially introduced by Wallston, Wallston, and DeVellis
related to UC. Most research on LOC and EE has focused in 1978, while Form C is designed for condition-specific
on mental illnesses, such as schizophrenia. 18-21 It would assessments. The scale shows strong internal consistency
be beneficial to understand how these constructs affect and stability over time. In addition, the validity of the

Volume 9 Issue 2 (2025) 110 doi: 10.36922/ejmo.8596