Ulcerative Colitis

Symptoms | Diagnosis and Screening | Treatment | For More Information

Ulcerative colitis is found in the colon. The inflammation begins at the rectum and extends up the colon in a continuous manner affecting the lining of the colon.

The cause of ulcerative colitis is unknown. The disease impacts each person differently and can remain dormant for years or flare-up more frequently. Ulcerative colitis is a chronic condition that cannot be cured but can be managed. It is very important to control the disease under the care of an IBD specialist, as those who have been diagnosed with colitis for a longer period of time are at a slightly higher risk of getting colon cancer. Your physician can help you lower your risk of developing cancer.

A variety of terms may be used to describe ulcerative colitis depending upon where the disease is located in the colon:

• Ulcerative proctitis – involves only the rectum
• Proctosigmoiditis – involves the rectum and sigmoid colon
• Distal colitis – involves only the left side of the colon
• Pancolitis – involves the entire colon

Ulcerative Colitis Symptoms

Two of the major ulcerative colitis symptoms are bloody stool and diarrhea. Loose stools occur when the lining of the intestine becomes inflamed and ulcerated and loses its ability to absorb water from the waste material that passes through the colon. That damage also can produce mucus and blood in the stool which can lead to anemia. Other symptoms include:

• Urgency to have a bowel movement
• Crampy abdominal pain – may be stronger on the left side
• Loss of appetite
• Weight loss
• Fatigue
• Children may fail to develop or grow properly

Keeping a food diary may be helpful in identifying foods that irritate your system. Eliminating those foods and eating bland, soft foods during flare-ups may help control your ulcerative colitis symptoms. Smaller, more frequent meals may help as well. Generally, when one's ulcerative colitis is under control, most foods and diets are very well tolerated. As there is currently no evidence suggesting that diet changes can decrease inflammation in the bowels, it is important to discuss a comprehensive treatment plan with your doctor.

Bouts of diarrhea can lead to a nutritional imbalance in your body. Therefore, people with ulcerative colitis should be sure to eat a healthy, well-balanced diet with foods from all food groups and include a daily multivitamin.

Develop some strategies for daily living with ulcerative colitis. When going out, find out where the restrooms are. If you are planning a trip, be sure to speak to your doctor about having enough medication, its generic name in case you run out or lose it and the names of doctors in the area you will be visiting.

Learning to live with ulcerative colitis will allow you to pursue the activities you’ve always enjoyed and allow you to lead a normal and healthy quality of life.

Ulcerative Colitis Diagnosis and Screening

To diagnose ulcerative colitis, doctors ask about the symptoms, do a physical exam and do a number of tests. Testing can help the doctor rule out other problems that can cause similar symptoms, such as Crohn’s disease, infection, hemorrhoidal bleeding, irritable bowel syndrome (IBS), or diverticulitis.

Tests that may be done include:

• A colonoscopy is a test where the doctor uses a thin, lighted tool to look at the inside of your entire colon. At the same time, the doctor may take a sample (biopsy) of the lining of the colon to substantiate a ulcerative colitis diagnosis.
• An x-ray, CT or MRI may be done to identify and evaluate inflammation.
• Blood and stool sample tests to look for infection or inflammation.

Ulcerative Colitis Treatment

Medications

Doctors often prescribe medicines to reduce inflammation, such as:

• Steroid medicines. These can help reduce or stop ulcerative colitis symptoms. They are only used for short periods because they can cause side effects, such as bone thinning (osteoporosis). 
• Aminosalicylates: These medicines control inflammation and prevent flare-ups, and are often the first line used given their favorable side effect profile
• Over-the-counter (OTC) pain relievers: Nonsteroidal Anti-inflammatory Drugs (NSAIDs) such as ibuprofen (Motrin), naproxen (Aleve), meloxicam (Mobic) can worsen inflammation in Crohn's disease. Acetaminophen (Tylenol) is safe to take for pain.
• Immunomodulators: You may need these medications if your disease is severe and aminosalicylates don't keep it from flaring up.
• Biologic therapies: These have recently been prescribed for patients with UC and are changing the way gastroenterologists treat IBD. These are the newest class of drugs for people suffering inflammatory bowel disease. They are made from antibodies that bind with certain molecules to block a particular action. Biologic drugs target specific pathways to help reduce inflammation and the chance of surgery.

Surgery

At some point, patients with ulcerative colitis may require surgery for severe disease or precancerous changes. It may be a desirable option when medical therapies are no longer effective. This is an effective cure for ulcerative colitis.

There are two common surgical approaches which may be recommended:

• Creation of an ileostomy and removal of the entire colon (colectomy). During an ileostomy surgeons bring the small bowel to the skin so that waste products may be emptied into a pouch attached to the abdomen.
• Ileoanal pouch anal anastomosis (IPAA): during this procedure a pouch is created from the small bowel and is attached to the anal sphincter muscle which allows patients to have normal bowel movements without the use of an external ostomy bag.

For More Information

For more information on ulcerative colitis symptoms, diagnosis and treatment, or to schedule an appointment with an IBD physician, please call 847.570.2903.