Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory bowel disease that affects the colon and rectum. In this condition, the lining of the colon becomes inflamed, with development of swelling and small open sores or ulcers.

 

Depending on the degree of involvement of the colon, this leads to frequent, loose stools with bleeding, urgent need to use the bathroom, and overproduction of mucus.

Symptoms

  • Diarrhea with frequent bowel movements, often with blood.
  • Abdominal pain and/or cramps.
  • Urgency to defecate.
  • Awakening from sleep during the night to have a bowel movement(s).
  • Rectal pain and pressure.
  • Weight loss.

Complications

  • Liver disease related to bile duct inflammation and scarring.
  • Inflammation of skin, joints and eyes.
  • Small increased risk of colon cancer after a specified duration of inflammation. 
  • Increased risk of blood clots in veins and arteries.

Cause

The cause of inflammation is unknown but is likely due to a combination of the microbiome, immune system and genetics. Inflammation then leads to damage to the colon lining. The goal of treatment is to regulate the immune system to prevent ongoing damage to the lining. Treatments do not cure the condition but control inflammation. In most instances, treatments will need to be taken long term. 

Treatment / Management

Ulcerative colitis is a life-long disease that requires long-term management of the conditions. Treatment for ulcerative colitis typically involves a combination of medication, lifestyle changes, and in some cases, surgery. The goal of treatment is to reduce inflammation, relieve symptoms, and improve quality of life.

 

Medications used to treat ulcerative colitis include:

  • Aminosalicylates, such as sulfasalazine or mesalamine, which can help to reduce inflammation in the colon and rectum.
  • Corticosteroids, such as prednisone or budesonide, which can help to reduce inflammation and suppress the immune system.
  • Immunomodulators, such as azathioprine, upacitinib, ozanimod, or 6-mercaptopurine, which can help to suppress the immune system and reduce inflammation.
  • Biologic therapy, such as infliximab, adalimumab, golimumab, vedolizumab, and ustekinumab.

Lifestyle changes that can help to manage ulcerative colitis symptoms include:

  • Eating a healthy diet.
  • Getting regular exercise.
  • Managing stress.
  • Surgery may be considered for people with ulcerative colitis who do not respond to other treatments or who have complications from the disease. The most common surgical procedure for ulcerative colitis is colectomy, which involves removing the colon and rectum.

Proctitis

Proctosigmoiditis

Distal Colitis

Pancolitis

FAQs

Ulcerative colitis is a type of inflammatory bowel disease that causes inflammation in the inner lining of the colon and rectum. This can lead to symptoms such as abdominal pain, diarrhea, and rectal bleeding.

The exact cause of ulcerative colitis is unknown, but it is thought to be related to a combination of genetic, environmental, and immune system factors.

Ulcerative colitis is usually diagnosed through a combination of a physical exam, blood and stool tests, and imaging tests such as a colonoscopy or CT scan.

Treatment for ulcerative colitis typically involves medications to reduce inflammation and manage symptoms, as well as lifestyle changes such as modifying the diet and avoiding triggers that can worsen the condition. In some cases, surgery may be necessary to remove the colon and rectum.

There is currently no cure for ulcerative colitis, but it can be managed with treatment and lifestyle changes.

Ulcerative colitis can increase the risk of developing colon cancer, especially if the disease is not well-controlled. Regular screenings and surveillance are important to detect any potential abnormalities early on.

Symptoms of ulcerative colitis can include abdominal pain, diarrhea (which may be bloody), fatigue, weight loss, and anemia.

Managing ulcerative colitis on a daily basis may involve taking medications as prescribed, avoiding triggers that can worsen the condition, eating a healthy diet, and staying hydrated. It is also important to communicate with a healthcare provider regularly to ensure that the treatment plan is effective.

Ulcerative colitis can potentially affect fertility, especially in women with active disease or who have had multiple surgeries related to the condition. It is important to discuss any fertility concerns with a healthcare provider.

Yes, there are numerous support resources available for people with ulcerative colitis, including online support groups, in-person support groups, and patient advocacy organizations. It can be helpful to connect with others who are living with the condition and share experiences and coping strategies.  The Crohn’s and Colitis Foundation has some excellent resources available online.