Ulcerative Colitis - Causes, Symptoms and Treatment

What Is Ulcerative Colitis?

Ulcerative colitis (UC) is an inflammatory bowel disease. It causes irritation, inflammation, and ulcers in the lining of your large intestine, or colon.

Ulcerative colitis is different from other diseases with similar symptoms, like Crohn’s disease and irritable bowel syndrome. There’s no cure, and people usually have symptom flare-ups off and on for life. But the right treatments can help you keep a handle on the disease.
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Causes of Ulcerative Colitis:

The exact cause of ulcerative colitis remains unknown. Previously, diet and stress were suspected, but now doctors know that these factors may aggravate but don't cause ulcerative colitis.

One possible cause is an immune system malfunction. When your immune system tries to fight off an invading virus or bacterium, an abnormal immune response causes the immune system to attack the cells in the digestive tract, too.

Heredity also seems to play a role in that ulcerative colitis is more common in people who have family members with the disease. However, most people with ulcerative colitis don't have this family history.
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Symptoms of Ulcerative Colitis:

The " main symptom of ulcerative colitis is diarrhea, often with blood or pus" . Other problems include:

• Abdominal pain and cramping
• Rectal pain
• Sudden urges to empty your colon right away
• Rectal bleeding — passing small amount of blood with stool
• Not feeling hungry
• Weight loss
• Feeling tired
• Fever
• Dehydration
• Joint pain or soreness
• Canker sores
• Eye pain when you look at a bright light
• Too few red blood cells, called anemia
• Skin sores
• Feeling like you haven’t completely emptied your colon after you use the bathroom
• Waking up at night to go
• Not being able to hold your stool in

Your symptoms can flare up, go away, and come back. Sometimes they might not bother you for weeks or years at a time.

Other gut diseases can have some of the same symptoms. Crohn’s disease causes inflammation, too, but it affects other places in your digestive tract. Ulcerative colitis involves only your large intestine and its lining. Irritable bowel syndrome has some of the same symptoms asUlcerative colitis, but it doesn’t cause inflammation or ulcers. Instead, it’s a problem with the muscles in your intestines.
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Risk factors:

Ulcerative colitis affects about the same number of women and men. Risk factors may include:

• Age. Ulcerative colitis usually begins before the age of 30. But, it can occur at any age, and some people may not develop the disease until after age 60.
• Family history. You're at higher risk if you have a close relative, such as a parent, sibling or child, with the disease.

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Complications:

Possible complications of ulcerative colitis include:

• Severe bleeding
• A hole in the colon (perforated colon)
• Severe dehydration
• Liver disease (rare)
• Bone loss (osteoporosis)
• Inflammation of your skin, joints and eyes
• An increased risk of colon cancer
• A rapidly swelling colon (toxic megacolon)
• Increased risk of blood clots in veins and arteries

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Diagnosis of Ulcerative Colitis:

• Blood tests. Doctor may suggest blood tests to check for anemia — a condition in which there aren't enough red blood cells to carry adequate oxygen to your tissues — or to check for signs of infection.
• Stool sample. White blood cells in your stool can indicate ulcerative colitis. A stool sample can also help rule out other disorders, such as infections caused by bacteria, viruses and parasites.
• Colonoscopy. This exam allows doctor to view your entire colon using a thin, flexible, lighted tube with an attached camera. During the procedure, doctor can also take small samples of tissue (biopsy) for laboratory analysis. Sometimes a tissue sample can help confirm a diagnosis.
• Flexible sigmoidoscopy. Doctor uses a slender, flexible, lighted tube to examine the rectum and sigmoid, the last portion of your colon. If your colon is severely inflamed, doctor may perform this test instead of a full colonoscopy.
• X-ray. If you have severe symptoms, doctor may use a standard X-ray of your abdominal area to rule out serious complications, such as a perforated colon.
• CT scan. A CT scan of your abdomen or pelvis may be performed if doctor suspects a complication from ulcerative colitis. A CT scan may also reveal how much of the colon is inflamed.
• Computerized tomography (CT) enterography and magnetic resonance (MR) enterography. Doctor may recommend one of these noninvasive tests if he or she wants to exclude any inflammation in the small intestine. These tests are more sensitive for finding inflammation in the bowel than are conventional imaging tests. MR enterography is a radiation-free alternative.
  

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Types of Ulcerative Colitis:

The type of ulcerative colitis you have depends on where it’s located in your body:

• Ulcerative proctitis is usually the mildest form. It’s confined to the area closest to your anus (rectum). Rectal bleeding may be the only sign of the disease.
• Proctosigmoiditis involves your rectum and the lower end of your colon (you may hear the doctor call it the sigmoid colon). You’ll have bloody diarrhea, belly cramps and pain, and you’ll have the urge to poop, but you won’t be able to (the doctor will call this tenesmus).
• Left-sided colitis causes cramps on that side of your belly. You’ll also have bloody diarrhea and you might lose weight without trying. You’ll have inflammation from your rectum up through the sigmoid and descending colon.
• Pancolitis often affects your entire colon. It can cause severe bouts of bloody diarrhea, belly cramps and pain, fatigue, and major weight loss.
• Acute severe ulcerative colitis is rare. It affects the entire colon and causes severe pain, heavy diarrhea, bleeding, and fever. You won’t be able to eat.

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Treatment for Ulcerative Colitis:

Ulcerative Colitis treatment has two main goals.

1. The first is to ease your symptoms and give your colon a chance to heal.
2. The second is to prevent more flare-ups. You may need a mix of diet changes, medication, or surgery to reach those goals.

• Diet. Food doesn’t cause ulcerative colitis, but some types can make your symptoms worse. You might find that soft, bland food doesn’t bother you as much as spicy or high-fiber dishes. If you can’t digest the sugar in milk called lactose (meaning you’re lactose intolerant), your doctor may tell you to avoid dairy products. A balanced diet with plenty of fiber, lean protein, fruits, and veggies should provide enough vitamins and nutrients.
• Medicine. Doctor may prescribe a few different kinds of drugs, including:
  • Antibiotics to fight infections and let your large intestine heal
  • Medicine to lower inflammation in your colon and control your symptoms. You may start by taking one type, called aminosalicylates. If those don’t work or your symptoms are more severe, your doctor may prescribe another type of anti-inflammatory drug, a corticosteroid.
  • Medicineto help stop your immune system’s attack on your colon
  • Biologics are drugs made from proteins in living cells instead of chemicals. They are for people with severe ulcerative colitis.
• Surgery. If other treatments don’t work or your Ulcerative Colitisis severe, you might need surgery to remove your colon. The doctor will call this a colectomy.

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Prognosis for Ulcerative Colitis:

For most people, ulcerative colitis is a chronic, or long-term condition. You’ll have flares and periods with no symptoms at all. A small number of people have one attack and are never troubled again. If you get ulcerative proctitis, you probably won’t need surgery and can live a normal life.

A small number of people, about 10% of those withulcerative colitis, have an initial attack and quickly get worse, with serious complications. For about 20% to 30% of people who have it, the disease spreads to the large intestine over time. This can turn into colon cancer, but about half the people who get it survive if doctors catch the disease early enough and remove their colon.

Request an appointment at Pace Hospitals.