Ulcerative Colitis

What is Ulcerative colitis?

Between 600,000 and 900,000 Americans suffer from ulcerative colitis (UC), a kind of inflammatory bowel disease (IBD) marked by persistent inflammation that primarily affects the rectum and occasionally other regions of the colon. Due to its lack of effects on deep tissues and its inability to affect other digestive system components, it is regarded as a superficial ailment. It differs from Crohn’s disease—another kind of IBD that it is sometimes mistaken for—in that inflammation in Crohn’s disease can occur anywhere in the digestive system and can penetrate deeply into the tissue.

In addition to rectal bleeding and bowel urgency, ulcerative colitis can produce abdominal pain, diarrhea, blood, or mucus in the stool (a strong need to defecate). These signs frequently appear gradually and fluctuate. Alternately, they could become better and disappear or get worse over time.

What are the types of ulcerative colitis?

What specifically causes ulcerative colitis is still a mystery. The immune system is hypothesized to malfunction and assault healthy cells in the digestive tract when this condition occurs. [1] According to Dr. McCutchen, imbalances in the gut microbiome, or the bacteria that normally inhabit our digestive tract, may be to blame for this alteration in immune function. The gut barrier can be more permeable to particles if the microbiome is out of balance. She notes that when that occurs, it may interfere with the processes necessary to maintain a healthy immune system.

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What are the causes and risk factors of ulcerative colitis?

Family background. People are more prone to develop ulcerative colitis if they have a close family (a parent, sibling, or kid) who has UC or another kind of IBD. [1]\sAge. According to Dr. McCutchen, diagnoses tend to be at their highest among persons between the ages of 15 and 30 and 50 and 70. Certain physical changes that take place while you grow may result in the development of UC if you have a genetic predisposition to the disorder. Why older persons also experience UC at higher rates is unknown. Dr. McCutchen speculates that it might be related to antibiotic exposure. Age-related immune system deterioration is another factor. [5] Ethnicity or race. Although anybody can acquire UC, Caucasians are more likely than other racial groups to do so, and those of Ashkenazi Jewish origin are most at risk. What causes these discrepancies is unknown. What signs and symptoms are present in ulcerative colitis?

The digestive system is where ulcerative colitis’s most common symptoms appear. These signs include:

  • Family history. People with a close relative (a parent, sibling, or child) with UC or other types of IBD are more likely to have ulcerative colitis. [1]
  • Age. There tends to be a peak in diagnoses in people ages 15 to 30 as well as those ages 50 to 70, Dr. McCutchen says. If you are genetically predisposed to UC, certain bodily changes that occur as you grow may cause the condition to develop. It’s unclear why older adults also get UC in higher numbers. It may have to do with exposure to antibiotics, Dr. McCutchen says. Additionally, the immune system weakens with age. [5]
  • Race or ethnicity. While anyone can develop UC, Caucasian people are more likely to develop UC compared to other races, and people of Ashkenazi Jewish descent are at the highest risk. It’s unclear what’s behind these differences.

What are the symptoms of ulcerative colitis?

Having a discussion with your doctor about your medical and family history is the first step in making an ulcerative colitis diagnosis. Additionally, Dr. McCutchen advises that you “be ready to mention when you first observed more frequent bowel movements or differences from your regular bowel motions.” Remember that symptoms can fluctuate, so what you initially believed to be a stomach illness may have actually been the earliest indications of UC. Additionally, Dr. McCutchen advises taking into account any inflammatory bowel disease, especially Crohn’s disease and UC, when considering family history.

Your gastroenterologist will likely perform some tests following a physical examination and evaluation of your medical history, such as: [7]

blood tests. This can check for other infections or digestive issues in addition to UC, anemia (low red blood cell count, a typical UC side effect), and other inflammatory bowel diseases.
Colonoscopy. According to Dr. McCutchen, this is the “gold standard” for UC diagnosis. To cleanse your colon, you first ingest a solution. A doctor may then introduce a thin tube with a light and camera at one end to check the colon and typically the small intestine and look for inflammation while you are under anesthesia. In order to check for indications of UC, the doctor may also extract a small sample of colon tissue (a biopsy).

Complications from any of these tests are quite unlikely, according to Dr. McCutchen. “Post-op bleeding may occur if you have a biopsy and an irritated colon, but the risk is modest,” she continues.

Ulcerative colitis treatment

The first line of treatment for ulcerative colitis is medication; if it is unsuccessful, surgery can be required. In order to prevent frequent flare-ups—a worsening or return of symptoms—the first goal of treatment is to put the patient into remission, according to Dr. McCutchen. When the rectum and colon are checked inside during a colonoscopy, the second objective, she adds, is to see repair of the lining.

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Dr. McCutchen notes that the majority of drugs try to lessen the inflammatory response in the intestines. She continues that the precise prescription depends on the location of the ailment and the intensity of the inflammation. Some options are [8, 9, 10]


The colon and rectum may need to be removed if treatments are ineffective. The last option, according to Dr. McCutchen, is to live without a colon or rectum. There are two varieties of surgery for ulcerative colitis: [9, 10]

Surgical procedure known as an ileoanal reservoir (J-pouch) involves the removal of the colon and, in certain cases, the rectum as well. The pouch is then fastened to the anus. You can still have regular bowel motions after this procedure, albeit they could happen more frequently.
Ileostomy: In this procedure, surgeons create an aperture in the belly and link the small intestine’s end to it after removing the colon, rectum, or other portions of it (called a stoma). Waste from the small intestine is collected via an ostomy pouch that is fastened to the stoma. Rather than having bowel movements throughout the day, you empty the ostomy pouch as it fills continuously.
Ulcerative colitis complications

Complications of ulcerative colitis

Anemia. According to Dr. McCutchen, the loss of blood might cause this decline in the number of red blood cells.
intestinal cancer. Anyone whose UC has advanced beyond ulcerative proctitis is particularly at risk. According to Dr. McCutchen, the risk also rises after eight years of having UC. She adds that surveillance biopsies and annual colonoscopies are routine procedures carried out by gastroenterologists to check for colorectal cancer.
harmful megacolon This unusual side effect of severe colon disease results in swelling, excruciating stomach discomfort, fever, rapid heartbeat, and diarrhea. If you have any of these symptoms, get in touch with your doctor right once. Toxic megacolon poses a life-threatening risk if untreated. Liver disease (12). The liver may also swell if UC is not well managed. As a result, the liver may develop illnesses such fatty liver disease, hepatitis, gallstones, and bile duct inflammation. Low bone mass or joint issues [13]. Steroids used long-term to treat UC might cause problems with the bones and joints. [4] A breach in the large intestine’s wall (called a perforation). [4] If this occurs, you will require immediate surgery to remove the colon, according to Dr. McCutchen. Similar to the surgeries mentioned above, you could or might not need a pouch to catch your feces after surgery.

How to prevent ulcerative colitis?

Unfortunately, ulcerative colitis cannot be stopped. The best thing someone with UC can do is make changes to their lifestyle to prevent flare-ups:

dietary adjustments There is no universal diet for UC because the small intestine, which is not involved in the condition, is where the majority of nutrients are absorbed. Keeping a food journal can help you keep track of flare-ups. You might observe that particular foods, such as those with lots of fiber, sugar, or fat, make your symptoms worse. Any dietary adjustments should be discussed with your healthcare provider or a registered dietitian with UC experience. [14]
stress reduction. Additionally, it seems that stress raises the possibility of flare-ups. [15] IBD patients should, in Dr. McCutchen’s words, “really encourage to see a therapist or mental health provider who is versed in IBD and can help them manage their symptoms.” Yoga [16], regular exercise [17], and mindfulness techniques [18] (such as meditation) may also help with ulcerative colitis symptom management.
Medication alterations.
Ibuprofen, naproxen, and other non-steroidal anti-inflammatories can lead to flare-ups. When necessary, consult your doctor about alternative pain management techniques.

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