Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that causes inflammation of the lining of the intestine, usually the colon (large intestine), leading to abdominal pain and severe diarrhea. It can be debilitating and has life-threatening complications.
Unlike Crohn's disease, UC usually affects only the lining of the colon and rectum, and occurs only in contiguous areas, not patches as in Crohn's disease.
There is no known cure, but treatments can alleviate the symptoms, allowing patients to live normally.
Symptoms of ulcerative colitis vary depending on its severity and where in the colon it occurs; UC is often classified by its location:
- Rectal bleeding or pain, or inability to move the bowels may indicate ulcerative proctitis, usually the mildest form of UC, affecting only the rectum.
- Bloody diarrhea, abdominal cramps and pain, and inability to move the bowels are symptoms of proctosigmoiditis, which affects the rectum and the lower part of the colon, the sigmoid colon.
- Bloody diarrhea, cramps and pain of the left side of the abdomen, and weight loss are associated with left-sided colitis, affecting the rectum, sigmoid, and descending colon.
- Severe bloody diarrhea, abdominal cramps and pain, fatigue, and weight loss may indicate pancolitis.
- Profuse diarrhea, severe pain, and sometimes dehydration and shock may indicate fulminant colitis, which is rare and has life-threatening complications.
You should see your WellStar physician if you have any of these symptoms, a persistent change in your bowel habits, or an unexplained fever lasting more than a couple of days.
Causes and Prevention
Although the cause of ulcerative colitis is unknown, researchers believe that heredity and an abnormal immune reaction to an infection may lead to the condition. Risk factors include:
- Age 30 to 40, although some people develop UC in their 50s or 60s
- Being white, especially of Jewish descent
- Family history
- Possibly use of Accutane®, an acne medication
- Non-steroidal anti-inflammatory drugs (NSAIDs) [link] can worsen UC.
Ulcerative colitis is usually diagnosed only after eliminating other conditions that can result in the same symptoms, like Crohn's disease, ischemic colitis, diverticulitis, irritable bowel syndrome, and colon cancer. Tests for UC include:
- Blood tests to check for anemia and infection
- Stool sample to detect while blood cells, indicating an inflammatory disease
- Colonoscopy - a thin, flexible tube with a camera is inserted to examine the colon and possibly take a biopsy
- Barium enema - the colon is coated with a dye to make it visible on an X-ray, usually only if a colonoscopy cannot be performed
- X-ray or computerized tomography (CT) scan of the entire abdominal area
Although ulcerative colitis cannot be cured, its symptoms can be mitigated, leading in some cases to long-term remission. There are many medications to treat the symptoms of UC. Their use will be closely tailored to your symptoms by your WellStar physician.
Certain foods aggravate may the symptoms of UC, and should be avoided during flare-ups. Suspect foods include:
- Dairy products
- High-fat foods
- High-fiber foods may aggravate diarrhea, cramps, and gas
- Gassy foods
- Alcoholic and caffeinated beverages can stimulate your intestines
- Carbonated drinks can produce gas
You may feel better if you eat more, smaller meals. Try to drink plenty of fluids, especially water, and consider nutritional supplements with your WellStar physician and dietitian.
Stress also aggravates the symptoms, and may be managed with exercise, biofeedback, and relaxation exercises.
In addition to lifestyle changes, there are drugs that treat the symptoms of the disease. Those that work well for some people do not work for others, and some have serious side effects. Your WellStar physician will help you evaluate the risks and potential benefits of your treatment options. Some types of drugs used are anti-inflammatories, immune system suppressors, nicotine patches, antibiotics, anti-diarrheals, laxatives, and nutritional supplements.
If these treatments fail to relieve your symptom, surgery to remove the entire colon and rectum eliminates ulcerative colitis. Your WellStar surgeon will construct a small pouch from the end of your small intestine, which will be attached to your anus, allowing for more normal elimination. This will allow you to avoid wearing a small bag to collect your waste.