Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that leads to long-lasting inflammation and sores called ulcers on the inner lining of the large intestine. Symptoms of this condition usually develop gradually and can become worse over time.
Many people with ulcerative colitis may have periods of remission. That means they may have times when no symptoms occur. Treatment for ulcerative colitis can significantly reduce symptoms and help keep patients in long-term remission though no cure is currently available.
In the United States, ulcerative colitis
affects about 1 million people. And the prevalence rate is 35 to 100 cases per
Due to the difference in the severity and
the location of ulcerative colitis, symptoms can vary. They usually involve:
- Diarrhea, often with blood or pus
- Abdominal pain and cramping
- Rectal pain
- Rectal bleeding — passing a small amount of blood with stool
- Urgency to defecate
- Inability to defecate despite urgency
- Weight loss
- Failure to grow in children
In addition to these, people with
ulcerative colitis may have less common symptoms such as:
- Joint pain or soreness
- Eye irritation
- Certain rashes
In most cases, people suffering from this
condition have mild to moderate symptoms.
According to its location, ulcerative
colitis can be divided into the following types:
- Ulcerative proctitis
In this condition, inflammation is confined
to the area closest to the anus. It tends to be the mildest type. People with
it may only have rectal bleeding.
Proctosigmoiditis affects the rectum and the lower end of the colon, causing bloody diarrhea, abdominal cramps and pain, and an inability to move the bowels.
- Left-sided colitis
Inflammation extending from the rectum up
through the sigmoid and descending colon is called left-sided colitis. Bloody
diarrhea, abdominal cramping and pain on the left as well as unintended weight
loss are common symptoms.
Pancolitis refers to the condition in which the entire colon is affected. Bouts of bloody diarrhea, abdominal cramps and pain, fatigue and significant weight loss may occur.
- Acute severe ulcerative colitis
Acute severe ulcerative colitis is a rare type. Similar to pancolitis, it affects the entire colon. It may result in severe pain, profuse diarrhea, bleeding, fever, and inability to eat.
The exact cause of ulcerative colitis
hasn’t been identified. But it is believed that three factors may play a role
in the development of this condition, including:
- Immune system malfunction
The immune system normally functions to protect you from viruses or bacteria. However, viruses or bacteria sometimes may cause your immune system to mistakenly attack the inner lining of the large intestine. This abnormal response leads to inflammation.
It seems that ulcerative colitis is more common in people with a family history of this condition. But more studies are needed to figure out the link between genes and ulcerative colitis.
According to some studies, environmental factors may increase the risk of ulcerative colitis, including medications such as anti-inflammatory drugs, antibiotics, a high-fat diet, certain foods, and stress.
Some risk factors may make you more likely
to have ulcerative colitis. They may include:
People who are between 15 and 30 or older
than 60 have a higher risk.
People of Jewish descent are more likely to
develop ulcerative colitis.
- Family history
People who have a family member with IBD
are at higher risk.
Possible complications that may be caused
by ulcerative colitis involve:
- 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
Your doctor may order one or more of the
following tests and procedures to diagnose ulcerative colitis:
- Blood tests
- Stool sample
- Flexible sigmoidoscopy
- CT scan
- Computerized tomography (CT) enterography and magnetic resonance (MR) enterography
Doctors usually treat ulcerative colitis
with medications and surgery.
Medications that will be used include anti-inflammatory drugs, immune system suppressors and other medications.
These drugs are often first used to treat
the condition. They include:
- 5-aminosalicylates, including sulfasalazine (Azulfidine), mesalamine (Asacol HD, Delzicol, others), balsalazide (Colazal) and olsalazine (Dipentum).
- Corticosteroids, including prednisone and hydrocortisone.
Immune system suppressors
By suppressing the immune system response that contributes to the inflammation, immune system suppressors can reduce inflammation. In order to receive a better effect, sometimes a combination of these drugs will be used.
- Azathioprine (Azasan, Imuran) and mercaptopurine (Purinethol, Purixan)
- Cyclosporine (Gengraf, Neoral, Sandimmune)
- Infliximab (Remicade), adalimumab (Humira) and golimumab (Simponi)
- Vedolizumab (Entyvio)
Other medications may be necessary to
manage your symptoms. Your doctor may recommend:
- Anti-diarrheal medications
- Pain relievers
- Iron supplements
Having surgery to remove your entire colon and rectum can often eliminate ulcerative colitis. It usually involves a procedure called ileal pouch anal anastomosis, in which a pouch is attached directly to your anus to enable you to expel waste relatively normally. However, this procedure may be not available sometimes. And you have to wear a bag to collect stool.
Keyword: ulcerative colitis.