Ulcerative colitis – Everything You Need to Know

ulcerative colitis

Ulcerative colitis is an inflammation of the colon, rectum, or both. The lining of the digestive tract becomes inflamed, resulting in the formation of small sores called ulcers. This ulcer may begin at the rectum but extends to the colon. The cells on the lining of the large intestine and rectum die.

As a result, it develops ulcers. It results in bleeding and pus discharge from the rectum. Ulcerative colitis is common among people of all ages, especially between 15-30.

Symptoms of ulcerative colitis

Symptoms of UC vary from person to person. These symptoms also change over time. Remission is the period when people with UC are diagnosed with this medical condition and show no to mild symptoms. A flare-up is a period when symptoms become severe.

The most common symptoms of ulcerative colitis include:

  • Diarrhea
  • Rectal pain
  • Sudden weight loss
  • Bloody stools
  • Stools with pus
  • Malnutrition
  • Stunt growth in children
  • Rectal bleeding
  • Mouth ulcers
  • Skin problems

Causes of ulcerative colitis

It is still under investigation why ulcerative colitis occurs. Previously, stress and a person’s diet were linked to the development of UC, but this assertion has recently been refuted. Researchers believe it happens due to active immune systems that attack the lining of the colon. However, more research is needed to know the exact cause of UC. 

Following factors may contribute to the UC:

Heredity factor: UC is linked with the heredity factor. Children may carry a gene of UC from their parents.

Environmental factors: Some foreign particles like bacteria, viruses, or any other antigen may trigger the immune response that leads to UC.

Immune disorders: If a person has one immunological disorder, he or she is more likely to get another. As a result, it may trigger the symptoms of ulcerative colitis.

Types of ulcerative colitis

The type of UC depends upon the part of the digestive tract it infects.

Ulcerative proctitis: It is the condition when the only rectum is affected. It is a mild form of ulcerative colitis. 

Left-sided colitis: It is also known as distal ulcerative colitis. It causes the inflammation of the area between splenic flexure and the distal colon. It causes symptoms like diarrhea, bloody stools, and pain on the left side.

Proctosigmoiditis: This condition causes the inflammation of the rectum and sigmoid colon. Symptoms include diarrhea, abdominal pain, and inability to pass stool, even with an urge to do so.

Pancolitis: It is also called extensive colitis. It is a severe type of ulcerative colitis that affects the entire colon. It may lead to severe fatigue, pain, and weight loss.

Diagnosis of ulcerative colitis

Your doctor may order you various tests to identify the type and severity of the disease.

It includes:

Blood test

A blood test is very helpful in identifying ulcerative colitis. This blood test is performed to see the level of red blood cells and inflammation. Your doctor may also order an antibody test.

Stool test

Ulcerative colitis can be identified by taking the samples of white blood cells and certain proteins from your stool. This stool sample is taken to see any infection-causing agents like bacteria or parasites.

Endoscopy

A flexible tube is used to examine the stomach, esophagus, and small intestine.

Biopsy

A biopsy is a procedure in which your doctor will take a sample of your tissues from the colon for examination.

CT scan

CT scan of abdomen and pelvis is performed to identify the ulcerative colitis. It also identifies the severity of the infection in the colon.

Flexible sigmoidoscopy

Flexible sigmoidoscopy commonly known as sigmoidoscopy is used to examine the sigmoid colon and descending colon. A long and flexible tube is inserted through the rectum to see the inflammation. If your doctor suspects the inflammation of a part of the colon, he may order you flexible sigmoidoscopy instead of a full colonoscopy.

Colonoscopy

It is a type of endoscopy in which a thin and flexible tube is inserted into your rectum. This tube has a camera at its tips. It shows a picture of the entire colon.

Sometimes tissue sample is also taken for further examination. Before performing this test, your doctor may ask you to reduce the solid food intake and switch to liquids. Laxatives are sometimes used to completely remove waste from the rectum and colon.

Colonoscopy is a very efficient method, and it helps in identifying colorectal cancer as well. Once you are diagnosed with UC, your doctor may perform frequent colonoscopy tests to see the level of inflammation and manage the recovery progress.

When to see a doctor

Once you are diagnosed with UC, monitor your symptoms. Immediately see your doctor if you experience the following symptoms:

  • Abdominal pain
  • Fever
  • Dehydration
  • Bloody stools
  • Rectal bleeding
  • Diarrhea
  • Joint pain

Treatment of ulcerative colitis

Ulcerative colitis is a chronic condition that requires proper treatment to reduce inflammation and prevent the symptoms from worsening.

Several drugs and medications are used to treat UC. The type depends upon the severity of the condition. A medication that works for someone may not work for other people, so sometimes it takes time to identify a proper medication that helps you.

Medications

The type of medication depends upon the severity and type of the UC. If your symptoms are mild, your doctor may prescribe you medicines to reduce the inflammation.

The medication usually includes 5-ASA drugs (5-aminosalicylates). Your doctor will recommend you take these drugs through the mouth or anus, depending upon the area of infection.

Corticosteroids are recommended in some circumstances – however, due to their side effects, most doctors avoid recommending them.

In some cases, antibiotics are recommended to reduce inflammation.

If you have severe symptoms of UC, your doctor may prescribe you a medication known as biologic. This drug is good at reducing inflammation and preventing the symptoms from worsening.

For the long-term treatment of ulcerative colitis, FDA (in 2018) had approved a medicine called Tofacitinib. This medication is taken orally and targets the inflammation-causing cells. However, recently FDA has issued a warning regarding the use of Tofacitinib. It can increase the risk of heart diseases and cancer. It is advisable to ask your doctor before using this medication.

If your symptoms are getting worst, like dehydration or bloody stool – you should immediately see your doctor.

Surgery

If medication is not working for a person, or symptoms are flaring up – your doctor may recommend surgery.

In some cases, only the infected part of the colon or rectum is removed. The small intestine is directly linked to the rectum. After this surgery, you will be able to pass your stool through the rectum, but you may experience frequent and watery stools.

In case of severe inflammation or damage, surgery involves the removal of the entire colon or rectum. A new pathway is made to excrete the waste via a pore through the abdominal wall. The small intestine is directly linked with the wall, and an outside bag collects the waste from it.

Surgery is usually recommended when you experience:

  • Bloody stools
  • Chronic symptoms
  • Tiny holes in the colon
  • Severe blockage

Lifestyle and natural remedies for UC

Some people tend to adopt lifestyle and dietary changes to improve their condition. It includes:

Bromelain: It is available in form of supplements. It is naturally found in pineapples. It is believed to reduce the symptoms of UC and inflammation.

Boswellia: This herb is found effective to reduce inflammation in patients with inflammatory bowel disease such as Crohn’s disease and UC.

Probiotics: Taking more probiotics through food can help you boost gut-friendly bacteria. When microbial flora is working properly – you will have fewer chances of getting inflammation or other gut diseases.

Limit dairy products: Some people have seen an improvement in their symptoms after limiting the intake of dairy products. That may be due to lactose intolerance of people with inflammatory bowel disease.

Drink plenty of fluids: Drink plenty of fluids, especially water. It is good to take more water than alcohol and caffeinated beverages. These drinks can make diarrhea worst.

Psyllium husk: Psyllium husk is a fiber supplement that regulates bowel movements by bulking up the stools. It prevents constipation and helps in alleviating the symptoms of UC. Some people may experience cramping or bloating after using psyllium husk, so it is good to talk to your doctor first.

Anti-inflammatory foods: Consume more foods that have anti-inflammatory properties like ginger, garlic, fatty fish, turmeric, and olive oil. There are plenty of other food choices, but ask your doctor before adding these foods to your diet.

Keep in mind these foods or natural remedies may not work for everyone. Many home remedies may worsen the symptoms of UC. You should always ask your doctor before undergoing any home remedy.

Ulcerative colitis risk factors

UC can affect both men and women equally. However, the following factors may increase the chance of developing UC:

Age: UC usually develops before 30. But you may get it at any age.

Family history: UC does not need family history to occur. But some people having UC do have a family history of inflammatory bowel diseases.

Race: Like other risk factors, anyone can develop ulcerative colitis. But it is more common in white people. If you have Ashkenazi Jewish descent, you are at least twice likely to get UC.

Prevention

There are certainly no ways to avoid the UC completely. However, you may adopt the following practices to prevent your symptoms from getting worst.

  • Limit high-fat foods
  • Increase intake of water
  • Eat 5-6 smaller meals instead of 3 large meals
  • Avoid dairy products
  • Take vitamin C or other multivitamin supplements at the recommendation of your doctor

Summary

Ulcerative colitis is a chronic condition that damages the lining of the colon and rectum. It sometimes develops ulcers on the surface of the colon. If you have symptoms of UC, you must visit your doctor. A healthcare provider will help you monitor your symptoms. You need to follow a treatment plan to improve your condition.

If you have mild symptoms, your doctor will help you get better with non-surgical options. It usually involves drug therapy. Some patients feel better after making lifestyle changes and using medications, and they do not need surgery. If you have severe UC, the ultimate way is the removal of the entire colon or rectum.

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