Counselling is usually misunderstood term and is usually confused by people with their own way of understanding it. Widely as per ‘OXFORD DICTIONARY’ counselling is-
“give advice to (a person) on social or personal problems, especially professionally.”
“the process of assisting and guiding clients, especially by a trained person on a professional basis, to resolve especially personal, social, or psychological problems and difficulties.”
WHAT COUNSELLING IS?
Counselling is a conversation between a trained counselor and the client in which the counselor listens carefully to his client to understand his life situations and make him explore the ways to deal with them to feel better to cope with the situation.
WHAT COUNSELLING IS?
- The process in which the counselor and the client set aside a time to discuss about the life situations of the client including the stressful and emotional feelings of the client.
- The process of bringing positive change in the mindset of the patient so that he can see things and situations more clearly; from different point of view.
- Maintaining the secrecy and confidentiality of the patient. Counselling provides a safe and confidential setting to address the concerns and issues that cause distress.
WHAT COUNSELLING IS NOT?
- To manipulate the client.
- To give advice to the client.
- To be judgemental and making a perception about the client.
- To expect from the client to behave in the same way as the counselor could have behaved in the same situation.
- To look into the situation from his own point of view.
- To get emotionally attached to the client.
Early signs of mental health problems are:
- Eating habits- eating too much or too little.
- Sleep- sleeping too much or too little.
- Energy- feeling lack of energy or no energy due to which there is no desire to do anything.
- Seclusion- pulling apart from people, avoiding company, desire to stay alone, no interest in meeting anyone.
- Smoking, drinking or drug usage more than normal limits.
- Numbness- feeling numb as if nothing matters and not giving reactions or always on edge, overreacting on small things.
- Feeling helpless.
- Feeling hopeless and despair.
- Confusion of mind causing difficulty in taking decisions even in normal life situations.
- Forgetful and slow in recollecting things.
- Upset on small things with mood changes which are very sudden.
- No sense of happiness about anything.
- Worried about everything and staying stressed and anxious all the time.
- Fighting with people around and shouting is the expression of anger.
- Relationship issues- difficulty in maintaining and sustaining any relationship.
- Fear of many things how so ever small they could be.
- Crowding of thoughts- mind always filled with thoughts which are hard to get rid off even after hard attempts.
- Delusions about things and believing in things which are not real.
- Self-harm or inflicting harm to others.
- Inability to cope with normal life situations and to keep pace with life.
WHAT IS ULCERATIVE COLITIS?
Ulcerative colitis is an INFLAMMATORY BOWEL DISEASE (IBD) in which there is long lasting inflammation of the large intestine (colon & rectum). There is irritation and swelling of the innermost lining of the colon which causes ulceration of the colon.
The inflammation usually starts from the rectum till lower colon but whole of the large intestine may be involved. Chron’s disease is another somewhat similar disease like ulcerative colitis but may affect any part of the gastro intestinal tract and all layers of bowel walls.
Ulcerative colitis being chronic disease is ongoing, life long disease with relapses or flare ups which means phases of good health and symptoms of inflammation.
Ulcerative colitis may be debilitating disease and sometimes can cause life threatening complications.
TYPES OF ULCERATIVE COLITIS:
- Ulcerative proctitis: in this the inflammation is just limited to the rectum only and episodes of bleeding is the only symptom seen in many patients except for cases with severe rectal inflammation where along with bleeding; urgency to stool, ineffectual urges & rectal pain are the symptoms.
Proctosigmoiditis: includes inflammation of rectum and sigmoid colon thus producing symptoms like- rectal bleeding, urgency and ineffectual urge to pass stool. Cramping with diarrhoea ( bloody diarrhoea) can also be seen in some patients.
Left sided colitis: in this inflammation starts from rectum and involves sigmoid and descending colon thus the left side of the large intestine is involved. Symptoms include bloody diarrhoea, cramps in abdomen, loss of weight and left sided abdominal pain.
Pancolitis: in pancolitis entire colon (left colon, right colon, transverse colon and the rectum) is involved. Symptoms include bloody diarrhoea, cramps and pain in abdomen, weight loss, fatigue, fever, night sweat and weakness.
Fulminant colitis(Acute severe ulcerative colitis): although rarely seen; fulminant colitis is most severe form of pancolitis (whole of the colon and rectum are involved). Symptoms include severe abdominal pain, diarrhoea with bleeding, dehydration and even shock. Colonic rupture and dilatation may also be seen.
Risk factors for Ulcerative Colitis
- Age: ulcerative colitis usually develops in thirties.
- Race: whites are more prone to develop ulcerative colitis but can effect any race.
- Family history: of ulcerative colitis also predisposes to develop ulcerative colitis.
- Autoimmune diseases: having any autoimmune disease can also predispose to development of ulcerative colitis.
Complications of ulcerative colitis
- Colonic rupture
- Colonic dilatation
- Colon cancer
- Arthritis ( inflammation of joints)
SYMPTOMS & CAUSES
- Diarrhoea usually with pus/ blood
- Pain in abdomen with cramping
- Ineffectual urge to pass stool
- Weight loss
- Failure to thrive in children
The exact cause of ulcerative colitis is not known till now but research and study shows that there is certain relation between the micro-organisms invading the gut and the body’s immune system. The immune system of the body attacks the gut mistakenly for the invading micro-organisms and causes inflammation.
Ulcerative colitis also seems to run in families so there is some genetic inheritance factor as well.
DIAGNOSIS & TREATMENT
The combination of symptoms of abdominal pain, diarrhoea and blood in stool would suggest towards diagnosing ulcerative colitis. Further investigations performed are:
- Blood test: blood test is performed to look for anaemia.
- Stool test: to look for WBC in stool which is positive for ulcerative colitis and to rule out similar symptom infections caused by bacterias, viruses and parasites.
- Colonoscopy: is performed to look at the lining of the intestine to check for inflammation and to collect sample for biopsy.
- Biopsy: is performed to see the severity of inflammation.
- Other investigations like CT scan, MRI and X ray can also be performed.
The treatment of ulcerative colitis revolves around relieving pain, diarrhoea, blood in stool, correction of anaemia and taking care of the immune attack.
The conventional treatment includes:
- Pain relievers for taking care of cramps and pain in abdomen.
- Antidiarrheal medicines for checking diarrhoea.
- Iron supplements for anaemia.
- Immunosuppressants to decrease the inflammation caused by immune system.
- Surgery: in severe cases removal of the inflamed part of the gut would help.
- Homeopathic medicines: on the contrary to all the procedures homeopathic medicines have been proved to be more effective in taking care of ulcerative colitis.
- Small meals: eating small, frequent meals rather than large amount at once should be advised as this would not put load on the intestine at once. Thus small frequent meals should be preferred.
- Plenty of liquids: keeping yourself hydrated with ample amount of water can help you feel easy with ulcerative colitis.
- No coffee, carbonated drinks: these products increase the motility of gut and can cause diarrhoea and inflammation as well.
- Manage weight: proper diet should be taken if weight loss has started.
- Spicy food and alcohol makes the symptoms of ulcerative colitis worse.
- Limit dairy products as excess consumption of dairy products also aggravates the symptoms of ulcerative colitis. Although buttermilk and curd in small quantities and low fat ones are helpful to keep the gut healthy.
- Limit fibre in diet: too much of fibres in diet would promote intestinal motility and diarrhoea. Limiting fibre in diet would help in improving symptoms of ulcerative colitis.
- Manage stress: stress and anxiety are taken to be related to gut motility and in case of inflammation may aggravate the condition. Various techniques can be used for managing stress like meditation, yoga, breathing exercises, relaxation techniques and regular physical exercise.
Various homeopathic medicines are available which can help a patient of ulcerative colitis and can control the flare ups along with the intensity of symptoms. Medicines should always be given after thorough case taking and analysis of the case. Medicines like ars alb, pulsatilla, podophyllum, nux vomica, silicea etc can be used for treating a case of ulcerative colitis but only after thorough analysis by a homeopathic physician.
DO’s And DON’Ts
- Eat small frequent meals.
- Drink plenty of water.
- Manage weight.
- Manage stress.
- Be physically active.
- Do meditation and yoga.
- Dont smoke.
- Dont take alcohol.
- Dont drink carbonated drinks.
- Dont take much fibre in diet.
- Dont drink coffee.
- Dont eat much spicy food.