I have been following Martin's latest journey over on 'Number Twos' with great interest, and it's lead me to reflect on the origins of my UC. Why exactly have I got ulcerative colitis?
The NACC (amongst most other organisations you might care to look at) pretty much states that nobody knows why (summary sheet). But there must be some clues. It can't be totally arbitrary. If the idea of genetic predisposition is correct, then surely there would be another poor soul in the family doubled up with a dribbly bottom and cramping gut? But there isn't. Unless they're keeping it very secret. So, what other factors could there be?
I was diagnosed in about 2003, and I guess there were increasing symptoms over a period of a year or more before this. This pretty much coincides with my beginnings in teaching. I qualified in 1999, after a year of placements/university, and spent my first three years in a failing school not doing much teaching, essentially learning how to manage a class . At the time I was of the opinion that I was pretty invincible, but in fact the job was taking its toll - eating my energy and, although it took me a long time to admit it to myself, causing me to become extremely stressed. When I left that school after three years I was mentally and physically shattered. Looking back, I can remember having to run from my hilariously under-resourced classroom down three flights of stairs to the toilet on a daily basis. I can clearly remember halting half way down, gripping the banister, gritting my teeth, and devoting every ounce of my being into not pooing myself. At the time I put this down to being just a 'regular' guy - it was always in the morning, before the start of lessons. In retrospect that seems utterly ridiculous, especially as it was often extremely loose (though I don't remember blood), but I'd never even heard of irritable bowel, never mind UC. I spent 10 weeks of the last year having counselling because I'd hit rock-bottom mentally.
So, could this build up of stress have caused the UC? There sure was a hell of a lot of repressed negativity And I'd never had any symptoms before... or had I?
When I was just 17 my parents split up. Without seeming trite, at the time it wasn't emotionally such a big deal. My dad was in the military and spent long periods away anyway. The worst was watching my mum fall apart. Around the same time I was plagued with a persistent inflammatory problem in my knees - like arthritis. Several doctors and blood tests could not pinpoint anything, and so I was repeatedly treated with Brufen (like ibuprofen) over a period of about 12 months. Knees swelled, consumed drugs, knees reduced, stopped drugs, knees swelled, took drugs, knees shrank, stopped drugs, knees swelled... ad infinitum until one day they just never swelled again (until the last 6 years). Was the inflammation caused by bad home vibes? Is this the real origin of my UC? Or did the prolonged prescription of anti-inflammatory (NSAIDs) medication actually damage my immune system/colon?
Could any of these things be isolated as a cause? Could the impact they had on my mental well-being be isolated as a cause? Would a doctor tell me that one or all of them were just the trigger to a chronic disease already lying in wait, like some afghan road-side bomb? Have you ever tried to discuss why you have colitis with your consultant? They're more evasive than a politician at an expenses hearing. I sometimes even wonder whether I have UC at all - maybe I've got something else entirely that just manifests itself in my bowel and limbs...
The single most conclusive discovery I have been able to make is that alcohol was definitely part of the problem. I drank pretty heavily (come on, I'm British) from the age of at least 17 until I started to cut down a year or so after the initial tentative diagnosis. It was undoubtedly a trigger to worsening symptoms. This is a fact corroborated by many sources e.g. Colitis UK. But maybe it was the initial cause too. Maybe I just drank too much... I don't drink any more - 4.5 years of teatotality this month - and the UC's not gone... but I don't get such severe episodes either.
So, why-o-why-o-why? Is the UC a sleeper agent in people like me, just waiting for the call to action? -Who gives the call? Why? When? Is it triggered by my own brain: anxiety, nerves, stress? Or is it triggered by me behaviour: drinking too much, too often? Or is it the result of misdiagnosis or mistreatment: too many NAIDs?
The fact is it IS triggered by all these things. But the question remains. What caused it in the first place?