Ulcerative Colitis

Ulcerative colitis (UC) is a form of chronic inflammatory bowel disease (IBD) that affects the tissue lining the colon and rectum. Ulcerative colitis is often discussed in contrast to Crohn’s disease—another, more common form of IBD, which can affect any part of a person’s gastrointestinal tract (GI tract).

Ulcerative colitis is generally characterized by severe inflammation along the colorectal wall. This irritation oftentimes results in large, open sores—called ulcers—to develop inside the body and in rare cases externally, on an affected patient’s back, chest and neck.  Severity of cases usually depends on how much of the colon is inflamed and can vary widely from person to person.

Like any form of IBD, ulcerative colitis affects people regardless of age and sex. The condition is more common is Caucasian patients under the age of 35, which is relatively young compared to the ages when most patients are diagnosed with a gastroenterological (GI) disorder.  Although there is a second age peak in patients over 60 developing new onset ulcerative colitis.

Like all forms of IBD, ulcerative colitis carries a large increase in the risk of developing colon cancer and routine screening examinations should be scheduled with your specialist as well as close follow up for treatment options.  The longer you have this disease the higher your risk for developing malignancy.

Causes of Ulcerative Colitis

There is significant evidence to suggest that ulcerative colitis is passed down genetically, through members of a family. If one of your family members has been diagnosed with inflammatory bowel disease, it is much more likely that you will be affected as well. In general, the disease is thought to be triggered when stimulants—either internal ones or antigens that originate from the environment—cause the immune system in a person’s body to react defensively and then fail to recover, or regain balance. For example, bacteria will enter the colon, causing the lining of the bowels to inflame as a way to prevent infection—but once the antigen is gone, the inflammation does not subside, causing the body to feel unnecessary fatigue as a result of being overworked.

Symptoms of Ulcerative Colitis

The most commonly reported symptoms of ulcerative colitis are diarrhea, stomach pain, cramping and rectal bleeding. If you are affected by ulcerative colitis, you may experience any combination of these symptoms, which may or may not show up at different levels of severity at different times. Symptoms vary widely, depending on the case.

Since the disease is closely related to the body’s immune system, patients may also experience fever, a loss of appetite, weight loss and other symptoms usually associated with illness. In the most severe cases, ulcerative colitis can even lead to joint pain (arthritis) or inflammation around the patient’s eyes. The condition has also been tied to several liver disorders.

Treatment of Ulcerative Colitis

Treatment of ulcerative colitis generally involves trying to promote intestinal healing, suppress symptoms and avoid “flare-ups.” Medication is available for these purposes, including simple over-the-counter medicines for people who are only experiencing mild symptoms. Some patients will require more aggressive medication management, and will need to discuss the risks and benefits of these medications with their gastroenterologist before starting any treatment.  Patients who have already been diagnosed should keep track of what they eat and how their bodies react to certain foods, so that they know what foods to avoid. This can vary widely as well, depending on the case. While some patients find that foods with a high fiber content help ease the digestion process, fibrous foods might trigger bouts of diarrhea in another patient.

In the most severe cases, a doctor may be able to perform surgery to ease symptoms, such as bowel obstruction, or to repair tissue that has been damaged as a result of the inflammation and persistent diarrhea. The surgery required is called resection surgery, which removes part of, or the entire diseased colon.  Unlike Crohn’s disease, removal of the colon actually cures ulcerative colitis.

Overall, inflammatory bowel diseases such as ulcerative colitis can be an embarrassing and burdensome condition to deal with—feel free to ask a colonoscopy question to one of our medical experts if you need advice on how to live with IBD or if you feel you need to be diagnosed.

 

Reviewed 12/12/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014