Ulcerative colitis is a chronic disease that affects the large intestine. It’s a type of inflammatory bowel disease (IBD) that causes inflammation in your colon, rectum, or both. Due to chronic inflammation, ulcers often form and can affect anywhere from a small portion of your large intestine to an area that targets more tissue. Oftentimes, after ulcers begin to form, they spread upward and can worsen without treatment. Your body reacts by increasing the speed at which food moves through the large intestine. This causes frequent bowel movements and can affect nutrient absorption. Ulcers can also lead to bleeding and discharge, which can be painful to experience. To better understand this chronic disease, we aim to thoroughly answer a commonly asked question: what is ulcerative colitis?
Causes of Ulcerative Colitis
Unfortunately, the causes of ulcerative colitis are still unclear. It is believed to be a result of an overactive immune system, but researchers are unsure as to why it attacks certain parts of the large intestine and not others.
Risk Factors
Ulcerative colitis seems to affect the same number of both men and women, but heredity plays a large role in your risk. You’re at a higher risk for developing this condition if you’re of Ashkenazi Jewish decent. While ulcerative colitis tends to begin before the age of 30, it can occur at any age.
Understanding the Types of Ulcerative Colitis
Ulcerative colitis is similar to Crohn’s disease, but there are a few key differences. For one, there are multiple sub-types of ulcerative colitis, each of which affects different areas of your large intestine. Symptoms for each vary therefore proper diagnosis will allow for a more targeted treatment. The different types of ulcerative colitis include:
- Ulcerative Proctitis – this affects only the end of your colon and therefore, symptoms are isolated to the rectum. This is considered to be a very mild type of ulcerative colitis and oftentimes is only associated with rectal bleeding.
- Proctosigmoiditis – this affects both the rectum and the sigmoid colon, which is the lower end of your colon. Symptoms vary and can be paired with varying degrees of abdominal pain and tenesmus.
- Left-Sided Colitis – inflammation for this type extends up from the rectum, through the left side of the sigmoid and descending colon. Pain may be isolated to the left side.
- Pancolitis – this type of ulcerative colitis affects the entire colon and is one of the more serious sub-types. Symptoms can be severe and result in significant weight loss when not properly managed.
- Fulminant Colitis – although rare, this is a potentially life-threatening form of colitis. It affects the entire colon and can lead to colon rupture or toxic megacolon.
To ensure that you’re managing your symptoms and avoiding any complications, understanding the type of ulcerative colitis is essential for the proper treatment. See your doctor if you present any symptoms or treatment efforts are not working.
Symptoms of Ulcerative Colitis
One of the earliest symptoms of ulcerative colitis is diarrhea. Over time, as your large intestine becomes increasingly inflamed, stools progressively loosen. This is often paired with abdominal pain that can vary in intensity, cramping, and a sudden and intense urge to use the bathroom throughout the day. The severity of symptoms tends to depend on the level of inflammation and whether ulcers have developed. Mucus or blood can be present in diarrhea if there are ulcers. Most people experience worsened symptoms in the morning that get better throughout the day.
Other common symptoms include fatigue, weight loss, anemia, elevated temperature, dehydration, a loss of appetite, rectal pain, malnutrition, nausea, skin problems, mouth sores, joint pain, and a constant urge to have bowel movements. Some people experience additional symptoms depending on the severity of their condition.
While ulcerative colitis is a chronic disease with no known cure. However, many people experience mild or absent symptoms for months, or even years, with the proper treatment and preventative actions. When symptoms are absent, it’s called remission. This doesn’t mean that you’ll never experience a flare-up again, but it is an indication that your treatment is working as it should.
Complications of Ulcerative Colitis
If left untreated, some cases of ulcerative colitis can become severe and cause an array of complications. Complications range from mild to severe and can become life-threatening if not addressed. Some of the common complications of untreated ulcerative colitis include colorectal cancer, toxic megacolon, inflammation of the skin, joints, and eyes, liver disease, osteoporosis, perforated colon, severe bleeding, and severe dehydration.
Diagnostic Tests for Ulcerative Colitis
To ensure proper treatment, your doctor will perform a number of diagnostic tests. This helps to rule out Crohn’s disease and better understand the location of ulcerative colitis. Some of the diagnostic tests include:
- Blood Tests – blood tests are done to determine the presence of anemia or inflammation.
- Stool Samples – this can help rule out parasites, infection, and see if there is blood present in your stool.
- Flexible Sigmoidoscopy – this allows your doctor to examine the lower part of your colon. Using a bendable tube that’s inserted into the anus, a light and camera projects images on a screen. A biopsy can be performed with the help of a flexible sigmoidoscopy.
- Colonoscopy – a colonoscopy is the exact same as a flexible sigmoidoscopy except that the entire colon is examined.
- X-Rays – while less common, x-rays can be used in certain circumstances so that your doctor can get a better understanding of the disease or alternate conditions that could be affecting your digestive system. Other imaging tests may also be used.
Treatment for Ulcerative Colitis
Unfortunately, there is no cure for ulcerative colitis. However, with the proper treatment, many people experience remission from their symptoms. Treatment minimizes disruptions from your everyday life and helps to reduce inflammation. Everyone who is suffering from ulcerative colitis will have different treatment plans, as they depend on individual circumstances, severity, and the location of the disease. Your doctor will work with you to find an effective treatment, but it may require some trial-and-error.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), some dietary measures may help relieve symptoms. These include:
- Eating smaller, more regular meals throughout the day
- Drinking plenty of water
- Avoiding caffeine and alcohol
- Avoiding carbonated beverages
- Keeping a food diary to understand triggers
- Following an elimination diet
- Consider a low fiber, lactose-free, low fat, or low salt diet depending on individual symptoms.
One of the most effective treatment options is medication. There are different options available, all of which help calm inflammation to allow your digestive tissue to heal. This helps reduce symptom prevalence and severity. Some medications commonly used include aminosalicylates, corticosteroids, immunomodulators, biologics, and janus kinase (JAK) inhibitors. While corticosteroids are effective in reducing inflammation, they can have adverse side effects and therefore doctors try to limit their use. Immunomodulators aim to change the way your immune system works so that it no longer attacks your large intestine. However, these are often used in conjunction with other medications for the best results. Some people, especially children, may need to take vitamin supplements or probiotics to help support any deficiencies due to lack of absorption.
If medications don’t work, or the side effects are excessive, your doctor may recommend undergoing surgery to treat your ulcerative colitis. Surgery tends to be reserved for very serious cases and involves removing your entire colon. This results in an ostomy—a small opening on the side of your abdominal wall to redirect waste out of your body. Ostomies can either be temporary or permanent, depending on the severity of the damage. In some cases, surgeons will leave the colon in and redirect waste so that the colon has time to heal from severe colitis while medications are reducing symptoms. A reversal surgery can then be done, and your ulcerative colitis can be managed with medications. In cases where the damage is too severe, the colon will need to be removed.
While ostomies can lead to a very drastic lifestyle change, they are lifesaving procedures. There are plenty of options for choosing a discrete and effective pouching system and many of the myths are untrue. You can still do everything you would normally do when you have an ostomy, you just need to make a few adjustments.
If you’re struggling to cope with your ostomy, consider joining a support group. To help make your transition as easy as possible, Byram Healthcare has an array of ostomy supplies that can be delivered to your door discretely and in a timely manner.
