What Is Ulcerative Colitis, the Ailment Afflicting Shinzo Abe of Japan?

Ulcerative colitis, the gastrointestinal affliction that has debilitated Prime Minister Shinzo Abe of Japan so badly that he is resigning, is a chronic inflammatory bowel disease, which is suffered by millions and can flare up unpredictably.

It irritates and inflames the innermost lining of the large intestine and rectum, causing ulcers or sores. Symptoms can include uncontrolled diarrhea, rectal bleeding, weight loss, diminished appetite, abdominal pain and frequent need to use the bathroom.

The disease can strike at a young age and worsen over time, as appeared to happen to Mr. Abe, 65. Doctors say they have also seen it develop in people in their 50s and older who had not suffered symptoms at a young age.

Inflammatory bowel disease also includes Crohn’s disease, which can disrupt the entire gastrointestinal tract.

Removal of the large intestine is considered a cure for ulcerative colitis, but that creates other complications. Surgeons must use part of the small intestine to replace the large intestine or create an artificial opening in the abdominal wall for the discharge of bodily waste, an operation known as a colostomy.

Dr. Ananthakrishnan said advances in treatments had sharply reduced the need for surgery. Twenty years ago, he said, one in five patients needed surgery, compared with one in 10 now.

Nonetheless, he said, even people who have responded to treatments can suffer flare-ups, which appeared to be the case for Mr. Abe, and that can “take a toll on functioning for such a high-level person.”

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