Ulcerative Colitis

Ulcerative colitis is a long lasting swelling and soreness (inflammation) of the colon (large intestine). In patients with ulcerative colitis, sores (ulcers) and inflammation of the inner lining of the colon lead to illness. Ulcerative colitis can also cause problems outside the digestive tract.

Ulcerative colitis is closely related to another condition of inflammation of the intestines called Crohn's disease. Together, they are frequently referred to as inflammatory bowel disease (IBD). Ulcerative colitis and Crohn's diseases are conditions that can last years to decades. Men and women are affected equally. They most commonly begin during adolescence and early adulthood.

SYMPTOMS

Common symptoms of ulcerative colitis include rectal bleeding and diarrhea. There is a wide range of symptoms among patients with this disease depending on how severe the disease is. Some of these symptoms are:

  • Abdominal pain or cramping.

  • Diarrhea.

  • Fever.

  • Tiredness (fatigue).

  • Weight loss.

  • Night sweats.

  • Rectal pain.

  • Feeling the immediate need to have a bowel movement (rectal urgency).

CAUSES

Ulcerative colitis is caused by increased activity of the immune system in the intestines. The immune system is the system that protects the body against disease such as harmful bacteria, viruses, fungi, and other foreign invaders. When the immune system overacts, it causes inflammation. The cause of the increased immune system activity is not known. This over activity causes long-lasting inflammation and ulceration. This condition may be passed down from your parents (inherited). Brothers, sisters, children, and parents of patients with IBD are more likely to develop these diseases. It is not contagious. This means you cannot catch it from someone else.

DIAGNOSIS

Your caregiver may suspect ulcerative colitis based on your symptoms and exam. Blood tests may confirm that there is a problem. You may be asked to submit a stool specimen for examination. X-rays and CT scans may be necessary. Ultimately, the diagnosis is usually made after a flexible tube is inserted via your anus and your colon is examined under sedation (colonoscopy). With this test, the specialist can take a tiny tissue sample from inside the bowel (biopsy). Examination of this biopsy tissue under a microscopy can reveal ulcerative colitis as the cause of your symptoms.

TREATMENT

  • There is no cure for ulcerative colitis.

  • Complications such as massive bleeding from the colon (hemorrhage), development of a hole in the colon (perforation), or the development of precancerous or cancerous changes of the colon may require surgery.

  • Medications are often used to decrease inflammation and control the immune system. These include medicines related to aspirin, steroid medications, and newer and stronger medications to slow down the immune system. Some medications may be used as suppositories or enemas. A number of other medications are used or have been studied. Your caregiver will make specific recommendations.

HOME CARE INSTRUCTIONS

  • There is no cure for ulcerative colitis disease. The best treatment is frequent checkups with your caregiver. Periodic reevaluation is important.

  • Symptoms such as diarrhea can be controlled with medications. Avoid foods that have a laxative effect such fresh fruit and vegetables and dairy products. During flare ups, you can rest your bowel by staying away from solid foods. Drink clear liquids frequently during the day. Electrolyte or rehydrating fluids are best. Your caregiver can help you with suggestions. Drink often to prevent dehydration. When diarrhea has cleared, eat smaller meals and more often. Avoid food additives and stimulants such as caffeine (coffee, tea, many sodas, or chocolate). Avoid dairy products. Enzyme supplements may help if you develop intolerance to a sugar in dairy products (lactose). Ask your caregiver or dietitian about specific dietary instructions.

  • If you had surgery, be sure you understand your care instructions thoroughly, including proper care of any surgical wounds.

  • Take any medications exactly as prescribed.

  • Try to maintain a positive attitude. Learn relaxation techniques such as self hypnosis, mental imaging, and muscle relaxation. If possible, avoid stresses that aggravate your condition. Exercise regularly. Follow your diet. Always get plenty of rest.

SEEK MEDICAL CARE IF:

  • Your symptoms fail to improve after a week or two of new treatment.

  • You experience continued weight loss.

  • You have ongoing crampy digestion or loose bowels.

  • You develop a new skin rash, skin sores, or eye problems.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have worsening of your symptoms or develop new symptoms.

  • You have an oral temperature above 102° F (38.9° C), not controlled by medicine.

  • You develop bloody diarrhea.

  • You have severe abdominal pain.