What is Ulcerative Colitis

Dr. G S Sindhu

Dr. G S Sindhu

Gastroenterologist, Manipal Patiala, 15 years of experience

September 9, 2021 Liver Section 403 Views

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What is the meaning of Ulcerative Colitis?

Ulcerative colitis is a type of Inflammatory Bowel Disease (IBD) in which the lining of the intestine becomes inflamed. This may result in the irritation and formation of ulcers (sores) in the digestive system over a prolonged time.  Ulcerative colitis usually affects the lower part of the large intestine (known as the colon) and the rectum.  The symptoms of ulcerative colitis develop gradually. In some cases, ulcerative colitis can cause serious complications. Ulcerative colitis does not have any known treatment, but doctors can give you a line of treatment to relieve the signs and symptoms associated with the disease. Ulcerative Colitis usually affects people of all age groups, but it is mostly seen in people between 15 and 35 years of age. It is also commonly seen in men above 50 years of age.

We will be discussing Ulcerative Colitis in detail –

  • What are the causes and risk factors of Ulcerative Colitis?
  • What are the types of Ulcerative Colitis?
  • What are the symptoms of Ulcerative Colitis?
  • When should a person with Ulcerative Colitis see a doctor?
  • How to diagnose Ulcerative Colitis?
  • What is the treatment for Ulcerative Colitis? 
  • How to prevent Ulcerative Colitis?
  • What are the complications of Ulcerative Colitis?

What are the causes and risk factors of Ulcerative Colitis?

The exact cause of ulcerative colitis is not known yet. Stress and a high-fat diet were previously considered to be risk factors, but the doctors later confirmed that these conditions can aggravate ulcerative colitis, but are not its causative factors.

Some of the risk factors that may be responsible for causing ulcerative colitis include:

  • Immune System-associated problems– A person with a weak immune system is more prone to various diseases, including Ulcerative Colitis. Conversely, an overactive immune system may also cause Ulcerative Colitis. The job of the immune system is to protect one’s body from infections. But, sometimes the immune system attacks the body itself leading to damage of tissues and inflammation. When a foreign antigen ( bacteria or virus) attacks the digestive tract lining, our body’s immune system tries to fight the bacteria and antigens to protect it. In this process, the active immune system sometimes also attacks the healthy digestive tract lining cells causing Ulcerative Colitis. ( Know more about- What is Peptic ulcers? )
  • Family History/ Genetic factors– In a few cases, ulcerative colitis may be genetic. People suffering from ulcerative colitis very often have a family history of the same. One is at a higher risk of developing ulcerative colitis if a close relative, such as a parent, child, or sibling is suffering from the same.
  • Age factor- Ulcerative colitis can occur in both sexes and at any age but is most commonly seen between 15 to 35 years of age. It is also commonly seen at an age of above 50 years, particularly in men.
  • Race/ Ethnicity– A particular race known as the Ashkenazi Jewish race is known to be more prone to ulcerative colitis. The white population is found to have more risk of developing Ulcerative Colitis.
  • NSAIDs (Nonsteroidal Anti-inflammatory Drugs)- Frequent usage of certain drugs like Ibuprofen increases the chance of Ulcerative Colitis.
  • Medications for Acne treatment- As per studies the drugs that are used for acne treatment may increase the risk of ulcerative colitis. However, there is no known explanation for the same yet. 

What are the types of Ulcerative Colitis?

Depending upon the location, Ulcerative Colitis are of the following types-

  1. Ulcerative proctitis– Here the swelling is present in the rectum ( area near the anus ) and the patient has only the symptom of rectal bleeding ( blood appears in the stools ).
  2. Proctosigmoiditis– Here the swelling is present in the rectum and lower end of the colon ( part of the large intestine). Patient has symptoms like abdominal pain, cramps and diarrhea. Also, patients may be unable to pass stools despite the urge to do so.
  3. Left-sided colitis- Swelling is present in rectum and upper part of the colon. Patients may experience severe urgency to pass stools, bloody diarrhea and severe abdominal cramping and pain.
  4. Pancolitis- Swelling is present in the entire colon. Patient has severe symptoms like heavy bleeding in stools, fatigue, a major amount of weight loss and severe abdominal pain.

What are the symptoms of Ulcerative Colitis?

The symptoms of ulcerative colitis may include:

  • Diarrhea and loss of fluids, nutrients ( Know more about- What is Diarrhea ? )
  • Tiredness
  • Nausea
  • Weight loss
  • Anemia- Due to excessive blood loss in stools ( Know more about- What is Anemia ? )
  • Rectal pain- Pain in the lower part of the abdomen
  • Rectal bleeding- This leads to small amounts of blood being seen in the stools. ( Know more about- What is Blood in Stools? )
  • Fever
  • Abdominal pain
  • Abdominal or belly cramps
  • Frequent bowel movements and frequent urgency to pass stools
  • Tenesmus- Inability of pass stools despite the urgency
  • Presence of pus, mucous or blood in the stools
  • Rashes on skin
  • Sores in mouth
  • Pain and swelling in joints
  • Painful red eyes
  • The disease of the liver
  • Lack of physical growth in children

Most people with Ulcerative Colitis have mild to moderate symptoms. 

One of the main causes of blood in stools is the problem of piles. In advanced cases of piles, patients are unable to sit or have excessive blood in stools, infections, and gangrene anemia. In such cases, the patient is advised to undergo Piles Surgery. There are many hospitals and doctors in India where Piles surgery is done with great success. (Know more about- What is Piles Surgery?)

When should a person with Ulcerative Colitis see a doctor?

One must visit the doctor if the above-stated symptoms remain for long durations. Also in case of the following conditions one must immediately see a doctor-

  • Excessive blood in stools
  • Severe abdominal pain and cramps
  • Prolonged uncontrolled diarrhea that doesn’t get treated with medications
  • Severe diarrhea and bowel movements that disturb sleep
  • High persistent fever for over two days

How to diagnose Ulcerative Colitis?

The doctor will take a complete history of your symptoms, along with your family history, and do a thorough physical examination to diagnose ulcerative colitis. 

Depending on the symptoms present, the doctor may ask you to do the following tests:

  • Blood tests – Blood tests are conducted to detect any signs of infection and anemia.
  • Stool test – The white blood cells or the presence of certain proteins in your stool can indicate the presence of ulcerative colitis. A stool sample can also help to diagnose other conditions, such as infections caused by bacteria, viruses, or parasites.
  • Colonoscopy – The doctor can look inside the intestine using a flexible, thin light tube that is attached to a small camera. This process is called colonoscopy. A small tissue sample can also be taken for examination during this test. ( Know more about – What is Colonoscopy? )
  • Flexible sigmoidoscopy – The doctor examines the large intestine or the rectum using a thin, flexible tube in this procedure. In case of a severe case of inflammation in the intestine, the doctor may opt to do this test instead of a complete colonoscopy.
  • CT Scan – The doctor may conduct a CT scan of the patient’s abdomen and pelvis region if there is any kind of an indication of complications in the intestine. A CT scan can show the swelling very clearly.
  • X-ray – If the patient’s symptoms are very severe, the doctor may want to take an X-ray of the abdomen to identify whether or not the large intestine is affected.

What is the treatment for Ulcerative Colitis?

Ulcerative colitis can usually be treated with the help of medication or surgery. The goal of treatment is to reduce inflammation and other symptoms related to ulcerative colitis.

  • Medications- The doctor may prescribe certain medications such as Mesalamine, Sulfasalazine, Balsalazide, 5-Aminosalicylates, and Olsalazine. These drugs control the symptoms by reducing inflammation and swelling in mild to moderate cases of ulcerative colitis.

In case of severe symptoms, the doctor may recommend the use of antibiotics. The doctor may also recommend the short-term use of corticosteroids in cases of severe ulcerative colitis.

  • Immuno-modulators- In case of an overactive immune system, the doctor may recommend the use of immunomodulators. These medications include methotrexate, azathioprine, or 6-mercaptopurine. These medicines help in calming down the overactive immune system.
  • Biologics– Medications known as Biologics may be used in moderate to severe cases of ulcerative colitis. These medicines target parts of the immune system to calm it down. Some of the medications under this category include adalimumab, golimumab, infliximab, vedolizumab.
  • Surgery- In case of excessive bleeding, life-threatening symptoms, a hole, or severe blockage in a part of the large intestine, the doctor recommends surgery. Colonoscopy and CT scans are used for testing before the surgery.

In case the patient’s symptoms get worse, it can lead to dehydration which is a serious complication and requires immediate hospitalization. 

How to prevent Ulcerative Colitis?

Although the exact cause of ulcerative colitis is unknown, one may take the following measures to prevent ulcerative colitis-

  • Consumption of foods that are less fatty.
  • Eat small portions of meals that are spread throughout the day.
  • Drink enough water throughout the day.
  • Include food items that are rich in fiber in your diet.
  • Limit milk and other dairy products intake. 
  • Eating a balanced diet that includes fresh fruits and vegetables.
  • Increase intake of food loaded with Vitamin C such as bell pepper, spinach, berries, and citrus fruits.

What are the complications of Ulcerative Colitis?

Ulcerative colitis may lead to following complications-

  • Severe bleeding leading to anemia
  • Severe dehydration that can be life threatening ( Know more about- What are the causes for Dehydration in children ? )
  • Perforated colon- A hole in the colon which is fatal condition
  • Osteoporosis ( Bone loss )
  • Severe swelling in the joints, skin and reddening in the eyes
  • Risk of Colon cancer is increased manifolds (Know more about- What is Colon Cancer? )
  • Toxic Megacolon- Here the colon ( lower part of the digestive tract ) undergoes rapid swelling ) 
  • The risk of blood clots increases in the blood vessels in the body.

We hope that we could answer all your queries about Ulcerative Colitis through this article.

If you want any more information and treatment of Ulcerative Colitis, contact a Gastroenterologist.

Our only aim is to provide you with information through this article and we do not recommend any medicine or treatment for the same. Only a doctor can give you the best advice and treatment plan.

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