Ulcerative colitis is a recurring form of IBD which involves tiny sores in the inside lining of the large intestine. The inflammation begins near the base of the colon, right near the bottom of the anus, and goes up in one constant series, reaching a different length depending on the case. When a minor portion of the lower part of the intestine is affected, it is a less serious type of ulcerative proctitis.

Ulcerative colitis is dissimilar to the ulcers found in other sections of the gastrointestinal system like the stomach and small intestine, but it has a large amount of similarities to Crohn’s illness, which is also a form of IBD. One of the chief distinctions between Crohn’s disease and ulcerative colitis is that Crohn’s infliction is not confined to the inner surface layer of the colon, and can spread to any area of the digestive system. However, ulcerative colitis is confined to the surface layer of the colon.

The source of ulcerative colitis is uncertain, but there is a great deal of research pointing to interactions between environmental components, intestinal microbes, immune irregularity, and inherited propensity being responsible. People with a relative who suffer from the condition are more likely to be affected by it. In spite of the various options available to help manage symptoms and put the condition into a state of remission, a definitive remedy does not exist.

Ulcerative colitis can affect people of all ages, but it is most prevalent in young children and those aged between 40-50. At this moment, Canada holds one of the greatest proportions and occurrences of diagnoses ever reported globally, with around 120,000 people diagnosed.

What is ulcerative colitis?

Ulcerative colitis is an ongoing issue in which your immune system inappropriately reacts, resulting in swelling and ulcers forming on the interior wall of the large intestine.

Ulcerative colitis can start out slowly and deteriorate as the time goes on. However, it can also start suddenly. Symptoms can range from mild to severe. During periods in which individuals present with symptoms, there may be phases of remission, during which symptoms vanish. Periods of remission can last for weeks or years. The aim of therapy is to make sure people stay in sustained remission for a lengthy period of time.

Does ulcerative colitis have another name?

Ulcerative colitis is an inflammatory bowel disease (IBD) . Crohn’s disease and microscopic colitis are two frequent forms of Inflammatory Bowel Disease.

How common is ulcerative colitis?

Studies indicate that anywhere from around six hundred thousand to nine hundred thousand individuals in the US are afflicted by ulcerative colitis.1,2

Who is more likely to have ulcerative colitis?

Ulcerative colitis is more likely to develop in people

between the ages of 15 and 30, although the disease may develop in people of any age 3
who have a first-degree relative—a parent, sibling, or child—with IBD
of Jewish descent 4

What are the complications of ulcerative colitis?

Ulcerative colitis can result in complications that accumulate over time, like

anemia , a condition in which you have fewer red blood cells than normal. Ulcerative colitis may lead to more than one type of anemia, including iron-deficiency anemia and anemia of inflammation or chronic disease .
bone problems , because ulcerative colitis and corticosteroids used to treat the disease can affect the bones. Bone problems include low bone mass , such as osteopenia or osteoporosis .
problems with growth and development in children , such as gaining less weight than normal, slowed growth, short stature, or delayed puberty .
colorectal cancer , because patients with long-standing ulcerative colitis that involves a third or more of the colon are at increased risk and require closer screening.

In certain instances, ulcerative colitis can result in severe, rapidly progressing problems that can be fatal. These difficulties necessitate a hospital visit or an immediate operation. Serious complications include

fulminant ulcerative colitis , which causes extremely severe symptoms, such as more than 10 bloody bowel movements in a day, often with fever, rapid heart rate, and severe anemia . 3,4 People with fulminant ulcerative colitis have a higher chance of developing other complications, such as toxic megacolon and perforation.
perforation , or a hole in the wall of the large intestine.
severe rectal bleeding , or passing a lot of blood from the rectum. In some cases, people with ulcerative colitis may have severe or heavy rectal bleeding that may require emergency surgery.
toxic megacolon , which occurs when inflammation spreads to the deep tissue layers of the large intestine, and the large intestine swells and stops working.

Severe ulcerative colitis or grave difficulties can result in extra issues, like intense anemia and lack of fluids. These issues could need medical care in a hospital with blood donations or medications injected into a vein to provide fluids, salts, and minerals.

Health problems affecting other parts of the body

In individuals with ulcerative colitis, inflammation can occur not only in the large intestine, but in other areas of the body as well.

joints, causing certain types of arthritis NIH external link
skin
eyes
liver and bile ducts, causing conditions such as primary sclerosing cholangitis

Individuals with ulcerative colitis possess an augmented chance of developing clots of blood in their circulatory system.

Colorectal cancer

The risk of developing colorectal cancer is heightened with ulcerative colitis. Individuals have an elevated risk of getting colorectal cancer if their ulcerative colitis encompasses a larger part of the large intestine, is more intense, began at an early age, or has been continual for an extended period. Individuals with ulcerative colitis are more susceptible to colorectal cancer if they have primary sclerosing cholangitis or have relatives who have had colorectal cancer.

Your healthcare provider may suggest a colonoscopy if you suffer from ulcerative colitis, to check for any signs of colorectal cancer. Testing for illnesses or diseases before any signs or symptoms have developed is referred to as screening. Screening can check for dysplasia—precancerous cells—or colorectal cancer. Diagnosing cancer early can improve chances for recovery.

Doctors generally advise individuals with ulcerative colitis to have colonoscopies every one to three years, beginning eight years after the onset of the condition. For individuals diagnosed with ulcerative colitis and primary biliary cholangitis, annually scheduled colonoscopies are generally the doctor’s recommended course of action.

Symptoms & Causes

What are the symptoms of ulcerative colitis?

Symptoms of ulcerative colitis vary from person to person. Common symptoms of ulcerative colitis include

diarrhea
passing blood with your stool or rectal bleeding
cramping and pain in the abdomen
passing mucus or pus with your stool
tenesmus, which means feeling a constant urge to have a bowel movement even though your bowel may be empty
an urgent need to have a bowel movement

Symptoms of ulcerative colitis may vary in severity. An illustration of more docile indicators could be having less than four bowel movements in a day, and occasionally, there may be traces of blood in feces. Significant signs may involve over 6 bowel movements a day and usually having bloody stools. In cases of the most intense kind of Ulcerative Colitis, you could have over 10 stools with blood in a single day.

Signs and symptoms may be stronger if ulcerative colitis is intensified or affects a larger part of the large intestine. These symptoms include

fatigue, or feeling tired
fever
nausea or vomiting
weight loss

At times, your symptoms can vanish for days, weeks or even years, resulting in a period of remission. After a time when your symptoms stopped, you may experience a relapse, or a comeback of the same symptoms.

What causes ulcerative colitis?

Doctors aren’t sure what causes ulcerative colitis. It is believed that particular elements may contribute to the development of ulcerative colitis by specialists.

Genes

Ulcerative colitis sometimes runs in families. Studies indicate that specific genetic factors can raise the likelihood of someone acquiring ulcerative colitis.

Abnormal immune reactions

Erratic responses of the immune system may be linked to the onset of ulcerative colitis. Immune responses that are not normal can cause swelling in the large intestine.

Microbiome

The bacteria, viruses, and fungi found in your digestive system that provide assistance with digestion are known as the microbiome. Investigations have discovered dissimilarities in the microbiomes of people who experience Inflammatory Bowel Disease (IBD) compared to those without IBD. Researchers are continuing to analyze the connection between the microbiome and Inflammatory Bowel Disease.

Environment

It is believed by specialists that ulcerative colitis may be caused by factors in the external environment including a person’s location and situation. Investigators are continuing to explore the interface between elements such as the immune system, genetics, and the microbiome, and individuals’ environments in regards to the probability of contracting ulcerative colitis.

Diagnosing Ulcerative Colitis

Your physician will carefully review your medical history. A blood test can be helpful in gauging the intensity of inflammation, to know if any blood loss has caused anemia and to get an overall picture of your health and nutrition. Stool sample analysis can sometimes be helpful.

It may take a while for a diagnosis to be determined, so keeping track of when symptoms appear, recording your feelings, and writing them down in a diary or journal can be useful. When you talk to your doctor about these indicators, they will be better able to diagnose you.

Your doctor will decide which of a few treatments is most suitable for figuring out your intestinal issues. X-rays are infrequently used today, however they provide your medical provider with a way to examine the shape of your intestine. The procedure requires you to undergo a barium enema. This creates a difference in brightness that allows the intestine to appear on an X-ray. Scopes are being used more frequently as of late to ascertain the characteristics and degree of the sickness. A doctor puts an implement inside the patient’s body through the anus using a sigmoidoscope or colonoscope in order to get an interior view of the colon. The scopes consist of a thin, bendable tube that is interiorly hollow and features a small flashlight and video recorder. A benefit of utilizing these techniques rather than a barium X-ray or a CT scan is that a doctor has the option to biopsy any potentially suspicious tissue during the assessment for further testing in the lab.

Once the exams and evaluations have been performed and other illnesses have been ruled out, your doctor may give you a diagnosis of ulcerative colitis.

Management of Ulcerative Colitis

Treating ulcerative colitis encompasses various approaches; it involves relieving the symptoms and problems associated with the illness as well as employing therapies to reduce the swelling. The objective is to treat the intestinal wall and remain in recovery.

Dietary and Lifestyle Modifications

Although nutrients are generally absorbed in the upper part of the digestive system, those with ulcerative colitis may still be deficient. Other elements may affect their diet. The signs of an illness can lead to abstaining from certain foods, resulting in an unbalanced diet. If there is too much blood loss, then there is a risk of developing anemia, and it is important to modify the diet to make up for the deficit.

Generally, improved nutrition in general can give the body the necessary elements to cure itself, but studies and medical experience demonstrate that altering the diet alone cannot control the illness. Depending on how much inflammation is present and where it is located, you may need to follow a personalized diet as well as take nutritional supplements.

Symptomatic Medication Therapy

The most distressing features of ulcerative colitis are the symptoms, and managing them, especially pain and diarrhea, can bring an improved existence. Several therapies are available to relieve diarrhea and pain. Eating different types of food could be advantageous and medications designed to relieve diarrhea play a substantial part. Pain medications such as analgesics can be beneficial in treating pain that isn’t alleviated by anti-inflammatory medications, as outlined here. It is usually recommended to use acetaminophen (Tylenol®) over medications like ibuprofen (Advil®, Motrin®), aspirin, and naproxen (Aleve®, Naprosyn®), which are known as non-steroidal anti-inflammatory drugs (NSAIDs), since these substances have the potential to cause stomach problems.

Anti-inflammatory Therapy

These come in many forms, using various body systems. A doctor may advise the use of any one of these medications on its own or in combination with others. It may take a while to decide on the proper treatment for somebody, since each instance of ulcerative colitis is one of a kind. It is possible that a combination of different administration types (taken orally or rectally) could be used depending on where the illness is located, to cover all of the affected regions.

Surgery

For people whose condition continues to be severe and does not improve with any type of medical treatment, they may need to have an operation.

Since ulcerative colitis only affects the large intestine, one method of addressing the issue is to simply remove it; however, this is not a permanent solution. Getting rid of the colon can trigger other signs and problems. Although there is a range of surgical tactics, typically during a colectomy a surgeon cuts away a portion or all of the colon, and then to the abdominal wall a new opening is made through which the last part of the bowel is routed and to which the patient can connect a detachable device for collecting feces. A decision about whether an ostomy is temporary or permanent will depend on the circumstances.