Ulcerative colitis (UL-sur-uh-tiv koe-LIE-tis) is an inflammatory bowel disease (IBD) that causes inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum. Symptoms usually develop over time, rather than suddenly. Ulcerative colitis can be debilitating and can sometimes lead to life-threatening complications. While it has no known cure, treatment can greatly reduce signs and Symptoms of the disease and bring about long-term remission.
Symptoms Can Include:
· Abdominal pain/discomfort
· Blood or pus in stool
· Weight loss
· Rectal bleeding
· Frequent, recurring diarrhea
· Reduced appetite
· Tenesmus: A sudden and constant feeling that you have to move your bowels
Ulcerative colitis (UC) symptoms can vary from person to person and depending on the part of the large intestine (colon) that’s affected and the severity of the inflammation.
Symptoms can range from mild to moderate to severe based on where the large intestine is inflamed. The inflammation that causes UC symptoms can sometimes affect other parts of the body, with symptoms resulting in areas such as the: Eyes, Skin & Joints.
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.
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.
· Race or ethnicity. Although whites have the highest risk of the disease, it can occur in any race. If you’re of Ashkenazi Jewish descent, your risk is even higher.
· Family history. You’re at higher risk if you have a close relative, such as a parent, sibling or child, with the disease.
In addition to symptoms ranging in severity, UC can lead to other serious complications. In some instances, your doctor or specialist may recommend surgery to repair damage in the large intestine.
These complications include:
· Profuse bleeding
· Rupture of the bowel
· Severe symptoms that do not respond to medication
· Increased risk of colon cancer, due to chronic inflammation of the colon
· Vitamin and mineral deficiencies
· Anemia—Over time, blood loss from inflammation and ulceration of the colon can lead to iron deficiency
· Vitamin D deficiency—For people with UC, decreased vitamin D can lead to bone loss such as osteopenia and/or osteoporosis. Corticosteroid use can make bone loss worse
Doctors often classify ulcerative colitis according to its location. Types of ulcerative colitis include:
- Ulcerative proctitis. Inflammation is confined to the area closest to the anus (rectum), and rectal bleeding may be the only sign of the disease.
- Proctosigmoiditis. Inflammation involves the rectum and sigmoid colon — the lower end of the colon. Signs and symptoms include bloody diarrhea, abdominal cramps and pain, and an inability to move the bowels in spite of the urge to do so (tenesmus).
- Left-sided colitis. Inflammation extends from the rectum up through the sigmoid and descending colon. Signs and symptoms include bloody diarrhea, abdominal cramping and pain on the left side, and urgency to defecate.
- Pancolitis. This type often affects the entire colon and causes bouts of bloody diarrhea that may be severe, abdominal cramps and pain, fatigue, and significant weight loss
Endoscopic procedures with tissue biopsy are the only way to definitively diagnose ulcerative colitis. Other types of tests can help rule out complications or other forms of inflammatory bowel disease, such as Crohn’s disease.
To help confirm a diagnosis of ulcerative colitis, you may have one or more of the following tests and procedures:
- Blood tests. Your 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 studies. White blood cells or certain proteins 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 your doctor to view your entire colon using a thin, flexible, lighted tube with a camera on the end. During the procedure, your doctor can also take small samples of tissue (biopsy) for laboratory analysis. A tissue sample is necessary to make the diagnosis.
- Flexible sigmoidoscopy. Your doctor uses a slender, flexible, lighted tube to examine the rectum and sigmoid colon — the lower end of your colon. If your colon is severely inflamed, your doctor may perform this test instead of a full colonoscopy.
- X-ray. If you have severe symptoms, your 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 your 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. Your 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.
When the large intestine becomes inflamed, symptoms may return abruptly or suddenly get more intense in the form of flare-ups. It’s important to have an honest conversation with your doctor. Being open about your symptoms will help you and your doctor make the right treatment plan for you. Ask any questions you may have to get the right information as you move towards your treatment goals.