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What Is Ulcerative Colitis?

Ulcerative colitis is an inflammatory bowel disease, and it can be a debilitating problem, but can also be hard to identify and treat. Your best bet is prevention and eating a healthy diet. Read more to learn about the causes, symptoms, and treatments.

9 minute read

Last Updated April 7, 2022

Ulcerative Colitis - Digestive Disease - 1MD

Ulcerative colitis is an inflammatory bowel disease that affects the lining of your large intestine. Inflammation causes small ulcers to form on the lining, and this usually begins in the rectum and spreads upward through the colon. 

This inflammation also causes you to empty your bowels more frequently. If the cells lining your intestinal wall die and form ulcers, these ulcers can bleed and discharge. 

Ulcerative Colitis Causes

Medical professionals believe that ulcerative colitis is caused by an overactive immune system that is sending out inflammatory responses too often. It is not clear why this happens, but there are certain factors thought to play a role in the development of the disease. 

Genetics can increase your risk if family members also have the disease, and other immune disorders also increase your risk for inflammatory-related diseases such as ulcerative colitis. 

Ulcerative Colitis Symptoms

The severity of symptoms for ulcerative colitis varies among people, and they can change over time. Once diagnosed, you may experience mild symptoms or none at all for certain periods of time, and this is known as remission. Symptoms are likely to reappear and can be severe. 

The common symptoms for ulcerative colitis include:

Abdominal pain
Diarrhea
♦ Fever
♦ Bloody stools
♦ Rectal pain
♦ Increased abdominal sounds
♦ Malnutrition and weight loss

Ulcerative colitis increases your risk for colon cancer, so once diagnosed, regular screenings are recommended. Without prompt and strict treatment, your risk for several other serious complications can arise.

♦ Kidney stones
♦ Intestinal bleeding
♦ Ruptured colon
♦ Blood infection
♦ Toxic megacolon
♦ Ankylosing spondylitis (inflamed spinal joints)
♦ Liver disease
♦ Ulcerative Colitis Diagnosis

Your doctor will use a series of tests to diagnose ulcerative colitis. This is important as the symptoms can mimic those of other diseases. An accurate diagnosis is needed for effective treatment. Testing often involves:

♦ An endoscopy to look at your esophagus, stomach, and small intestine
♦ A colonoscopy to examine your colon
♦ A biopsy to analyze tissues taken from the lining of your rectum
♦ Blood tests are also used to look for anemia and inflammatory proteins.
♦ Ulcerative Colitis Treatment

Ulcerative colitis is a chronic condition, and there is no cure. Treatments are designed to reduce and control inflammation that triggers symptoms and to promote longer remission times. 

Medications are the first approach, specifically those designed to block and reduce inflammation. Should symptoms become too severe, hospitalization or surgery will be required. Patients typically end up in the hospital as a result of dehydration and loss of electrolytes through chronic diarrhea

Ulcerative Colitis Diet

There is not a specific diet designed to help ulcerative colitis because each person reacts to foods differently. There are guidelines that exist to help you choose foods that can prevent a flare-up and keep inflammation under control.

1. Watch your fiber: Eating fiber during a remission will keep you regular and can improve bowel movements. During a flare, however, too much fiber slowing down the digestive process can be a problem.

2. Eat a low-fat diet: Low-fat diets have been shown to delay flare-ups. If you do include fats in your diet, choose healthier versions like olive oil and omega-3 fatty acids. 

3. Get vitamin C: Vitamin C has been found to have a protective effect on your intestines, and diets rich in vitamin C have been linked with prolonged periods of remissions. 

It is also advised to keep a food diary so you can understand how certain foods affect you. Recording what you eat and your bowel movements and symptoms can help you identify which foods cause upset.

Natural Treatments for Ulcerative Colitis

Certain medications for ulcerative colitis can have serious side effects, so it’s worth it to try more natural treatments to manage your ulcerative colitis symptoms.

Probiotics: The beneficial bacteria living in your gut help to promote overall gut health. They help reduce and control inflammation so eating foods with probiotics such as yogurt or kimchi or taking probiotic supplements, can help reduce ulcerative colitis symptoms.

Bromelain: This enzyme can be found as a supplement or in pineapples and can ease the symptoms of colitis and reduce flare-ups.

Boswellia Serrata: This herb has been shown to stop some of the chemical reactions that cause inflammation in the body.

Turmeric: This spice is both a powerful antioxidant and anti-inflammatory agent and can help reduce symptoms and flare-ups.

Ulcerative Colitis Surgery

Surgery only becomes necessary if there have been significant chronic debilitating symptoms such as perforation to your colon, severe blockage, or large amounts of blood loss. CT scans are able to detect this level of damage, and then you will be scheduled for surgery.

The procedure involves removing your colon and creating a new pathway for waste. This new path comes from a small opening in your abdominal wall to the end of your rectum. The outer muscles of the rectum remain, but any diseases portion is completely removed, and you can pass stools as normal.

What Are the Variations of Ulcerative Colitis?

Ulcerative colitis is classified according to its location along your digestive tract. The different variations are:

♦ Ulcerative proctitis is confined to the rectum, and rectal bleeding is the most common sign.

♦ Proctosigmoiditis involves the rectum and sigmoid colon (lower end), and you will experience cramps, diarrhea, and an inability to move bowels.

♦ Left-sided colitis is marked by inflammation from the rectum through the sigmoid and descending colon.

♦ Pancolitis affects the entire colon and causes bouts of severe bloody diarrhea.

♦ Acute severe ulcerative colitis is the rarest form that affects the entire colon and causes severe pain, inability to eat, and profuse diarrhea.

Ulcerative Colitis Statistics

♦ In the United States, ulcerative colitis affects 15 people out of every 100,000.

♦ The risk of colon cancer increases significantly for those who have had ulcerative colitis for longer than 8 years.

♦ One in five ulcerative colitis patients will require surgery in their lifetime.

♦ Ulcerative colitis can develop at any age but typically appears between the ages of 15 and 30.

♦ Ulcerative colitis is more common among those of Caucasian background.

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Ulcerative Colitis and Children

Ulcerative colitis can be present in children and is typically diagnosed around ten years of age. The symptoms for children are similar to that in adults, and they may also experience anemia, unexplained weight loss, and malnutrition. 

Prompt treatment is essential for children, as ulcerative colitis can significantly impact their health and quality of life. The treatments are more limited because of possible complications, and medications are used to manage the inflammation. 

What Is the Long-Term Outlook?

There is no cure for ulcerative colitis with the exception of surgically removing the colon and rectum. Medical therapy is the first step to help reduce symptoms and control inflammation. Surgery is a last resort and is reserved for those with severe symptoms and a disrupted quality of life. 

Once diagnosed, you need to work closely with your doctor, and follow their recommended treatment plan in order to get the best possible outlook.