Ulcerative Colitis

Ulcerative colitis is an incurable form of inflammatory bowel disease (IBD). It causes the innermost lining of your colon and rectum to become inflamed, resulting in severe diarrhea and stomach pain.

Ulcerative colitis can greatly affect your quality of life because it can be painful and limit your activities. In some cases, it can have life-threatening complications including a hole in your colon; kidney stones; osteoporosis; severe bleeding; severe dehydration; inflammation of your skin, eyes and joints; swelling in your colon and increased risk of colon cancer.

Treatment can help to control your symptoms and improve your quality of life. Your ulcerative colitis can go into remission with the right treatment.

Ulcerative colitis is similar to Crohn's disease, another inflammatory bowel disease. Both cause inflammation and ulcers in your intestine. Crohn's can affect various parts of your colon. Ulcerative colitis usually is contained to a single area, from the rectum to the colon.

You Are at Risk for Ulcerative Colitis if You:

  • Have a family history of ulcerative colitis
  • Are younger than age 30
  • Are a certain ethnicity – it occurs most in white people, but the risk is higher among people of Eastern European Jewish (Ashkenazi) descent
  • Have had a virus or bacteria
  • Use the medication isotretinonin to treat acne; the link between this drug and ulcerative colitis is not certain

Doctors don't really know what causes ulcerative colitis. Heredity (family history) and abnormalities in the immune system may play a role.

Symptoms

Ulcerative colitis is classified according to where it occurs in your body, and your symptoms depend on the location.

Symptoms may come and go. Ulcerative colitis is chronic (long term) but doesn't usually get worse over time, especially if you have a mild form of the disease.

  • Ulcerative proctitis – The mildest form of ulcerative colitis; inflammation is in the rectal area
    • Rectal bleeding
    • Rectal pain
    • Feeling of needing to have a bowel movement urgently
  • Proctosigmoiditis – Inflammation in the rectum and lower area of the colon
    • Stomach pain and cramping
    • Bloody diarrhea
    • Trouble having bowel movements despite the urge to go
  • Left-sided colitis – Inflammation from the rectum through the sigmoid and descending colon in the upper-left abdomen
    • Stomach pain and cramping on left side
    • Bloody diarrhea
    • Weight loss
  • Pancolitis – Inflammation of entire colon
    • Stomach pain and cramping
    • Bloody diarrhea
    • Significant weight loss
    • Tiredness
  • Fulminant colitis – The most rare form of ulcerative colitis; can be life threatening; inflammation of the entire colon
    • Extreme diarrhea
    • Shock
    • Dehydration

Any significant change in your health, including bowel patterns, is a reason to talk to your doctor. That's especially true if you have any of these symptoms:

  • Diarrhea that doesn't get better with over-the-counter medications
  • Stomach pain
  • Blood in your stool
  • Fever for more than a couple of days

Diagnosis

The diagnosis of ulcerative colitis is a process of ruling out other conditions that have some similar symptoms.

Tests your doctor may recommend include:

  • Blood tests
  • Fecal occult blood test (stool)
  • Flexible sigmoidoscopy – Your doctor inserts a flexible tube in your anus and views pictures on a monitor to see inside your colon and rectum
  • Colonoscopy – Your doctor inserts a flexible tube in your anus and views pictures of your colon on a monitor
  • Capsule endoscopy – You swallow a capsule to get pictures of your digestive tract for your doctor to review
  • Imaging including X-rays and CT (computed tomography) scans
  • Barium enema X-ray – Your doctor gives you an enema to coat the lining of your bowls with a dye (barium), which helps show your rectum, colon and part of your intestine on X-rays
  • Double balloon endoscopy – Your doctor inserts an endoscope (long tube) down your throat to see inside you, from your esophagus to your colon

Treatment

Ulcerative colitis is not curable. Treatment is focused on reducing the inflammation in your digestive tract to improve your symptoms. Treatment also aims to prevent complications. Usually, treatment is medication and, sometimes, surgery. Our gastroenterology specialists are experienced in treating every colorectal condition, including ulcerative colitis.

Medication

Medications to treat ulcerative colitis include:

  • Anti-inflammatory drugs
  • Immune system suppressor drugs
  • Antibiotics
  • Anti-diarrheal drugs
  • Pain relieving drugs
  • Iron supplements

All medications have side effects. Talk to your doctor about the risks and benefits of any medications you take.

Surgery

Your doctor may recommend surgery if your ulcerative colitis doesn't respond to other treatment.

Surgery to treat ulcerative colitis involves removing your colon and rectum (proctocolectomy). You can still have normal bowel movements after this surgery with an ileoanal anastomosis procedure. A pouch that attaches to your anus is created at the end of your small intestine.

How to Prevent Ulcerative Colitis

The cause of ulcerative colitis is not known, but stress can make it worse. If you have ulcerative colitis, you may benefit from managing your stress with:

  • Relaxation exercises
  • Deep breathing
  • Biofeedback
  • Counseling

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