Ulcerative Colitis

What Is Ulcerative Colitis?

Ulcerative colitis is a chronic inflammatory bowel disease that causes inflammation and ulcers in the lining of your colon (large intestine) and rectum. This inflammation can lead to diarrhea, bloody stools, and abdominal pain.

What is the difference between ulcerative colitis and colitis?

Ulcerative colitis is a type of colitis. Both conditions lead to inflammation in the colon, but ulcerative colitis is a chronic condition that results in ulcers forming in the inner lining of the colon.

What are the types of ulcerative colitis?

Depending on what part of your colon is affected, your doctor may diagnose you with:

• Left-sided colitis — Affects the left side of your colon, which extends from your rectum to the bend in your colon near your spleen.
• Pancolitis — The most severe form of ulcerative colitis, causing inflammation that affects your entire colon.
• Proctosigmoiditis — Affects the lower part of your colon, called your rectum and sigmoid colon.
• Ulcerative proctitis — A milder form of ulcerative colitis that affects only the lower part of your colon, called your rectum.

How common is ulcerative colitis?

According to the National Institute of Diabetes and Digestive and Kidney Diseases, ulcerative colitis affects 600,000 to 900,000 people in the U.S.

What causes ulcerative colitis?

Researchers aren’t sure what causes ulcerative colitis.

However, similar to other inflammatory bowel diseases, it may be linked to:

• Genetics.
• Environmental exposures.
• An overactive immune response to normal intestinal bacteria.

What can cause an ulcerative colitis flare-up?

Stress and certain foods can trigger a flare-up of ulcerative colitis symptoms in some people. Other flare-ups can be caused by medications, infections, or changes in routines.

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What Are the Signs and Symptoms of Ulcerative Colitis?

Common symptoms of ulcerative colitis include:

• Abdominal cramps and pain.
• Anemia.
• Appetite loss.
• Diarrhea.
• Fatigue.
• Fever.
• Nausea.
• Rectal bleeding.
• Weakness.
• Weight loss.

When should I see a doctor about my ulcerative colitis symptoms?

If you have symptoms of ulcerative colitis, you should schedule an appointment with your doctor right away. Early treatment can improve your quality of life and reduce your risk of complications. If you are having emergency symptoms — such as severe abdominal pain or bleeding — you should go to the nearest hospital Emergency Department.

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How Do You Diagnose Ulcerative Colitis?

Your doctor may suspect you have ulcerative colitis based on your symptoms and may order testing to confirm the diagnosis.

What to expect during your visit

If your doctor suspects ulcerative colitis, they will:

• Ask about your symptoms.
• Perform a physical exam.
• Order other tests.
• Review your health history and medications.

Tests to diagnose ulcerative colitis

Tests to diagnose ulcerative colitis may include:

• Biopsy — A procedure that involves taking a small sample of colon tissue (2-4 mm) for examination in a lab. A biopsy may be performed during a colonoscopy or flexible sigmoidoscopy exam.
• Blood tests — Blood tests can check for signs of anemia and other signs of ulcerative colitis.
• Colonoscopy — A test that uses a lighted tube with a camera on the end to examine the lining of your entire colon.
• Flexible sigmoidoscopy — A test that uses a lighted tube with a camera on the end to examine your rectum and lower colon.
• Stool examination — A test called a fecal calprotectin test can look for signs of colon inflammation in your stool.

Ulcerative colitis prognosis

Approximately 50% of people who are diagnosed with ulcerative colitis have mild symptoms that can be controlled with medication. More severe symptoms may require surgery to provide a cure.

People with ulcerative colitis will need ongoing follow-up care to manage symptoms and colonoscopies to look for signs of colon cancer.

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How Do You Treat Ulcerative Colitis?

The goals of ulcerative colitis treatment are to reduce flare-ups, control symptoms, help your colon heal, and reduce long-term damage to your colon.

Your doctor may recommend treatment options, including:

Dietary changes

Avoiding certain foods may help ease ulcerative colitis symptoms.

Although food triggers can be different for each person, common items to avoid may include:

• Dairy (due to lactose intolerance).
• Highly seasoned foods.
• High-fiber foods.

Medication to treat ulcerative colitis

Many types of medicines are available to treat ulcerative colitis. Your doctor will recommend the best medication based on your condition and symptoms.

Medications to treat ulcerative colitis include:

• Aminosalicylates — To treat inflammation.
• Antibiotics — To treat or prevent infections.
• Corticosteroids — To suppress the immune system and reduce inflammation.
• Immunomodulators — To suppress the immune system and reduce inflammation.
• TNF inhibitors — To prevent inflammation by blocking a protein called TNF-alpha.
• Probiotics — Increase healthy bacteria in your gut.

Surgery for ulcerative colitis

If your ulcerative colitis does not respond to medicine, or if you develop cancer, you may need ulcerative colitis surgery to remove your colon. In most cases, your surgeon will remove your entire colon and rectum, which will cure your ulcerative colitis and eliminate your colon cancer risk.

After your colon is removed, you may have a permanent end ileostomy (stoma bag) to collect stool outside your body or an ileal pouch anal anastomosis (no external bag) to allow for normal bowel function. Your doctor will let you know which option is right for you.

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