Ulcerative Colotis

What is Ulcerative Colitis?
Ulcerative colitis is a chronic, recurring disease of the colon. The colon lining becomes inflamed and ulcerated. These open ulcerations can bleed and produce pus and mucous. The inflammation usually begins in the rectum and lower colon, but it may also involve the entire colon. With ulcerative colitis the inflammation extends up the colon in a continuous manner; there are no normal patches or skipped areas as there are with Crohn’s disease. Ulcerative colitis affects men and women equally, and is usually diagnosed for the first time in people in their 20’s.

The cause of ulcerative colitis is still unknown. It is thought that there is an inherited component as well as a defect in the immune response. Some speculate that environmental factors may also play a role. It is probable that a combination of factors is responsible.

Symptoms of Ulcerative Colitis
Usually the first sign of ulcerative colitis is loose stools that are often bloody. This may be accompanied by abdominal cramping and an urgency to move your bowels. A decreased appetite, weight loss and fatigue are common symptoms as well. Some patients with ulcerative colitis will have skin lesions, joint pain, eye inflammation and liver disorders. Approximately half of all patients with ulcerative colitis have very mild symptoms. Symptoms can also come and go, with long periods between flare-ups.

Diagnosis of Ulcerative Colitis
A diagnosis of ulcerative colitis can be suspected based on the presenting symptoms. Your doctor initially may order blood work and stool tests. Your doctor will also want to perform a colonoscopy to directly visualize the lining of the colon. This is an out-patient procedure to examine your colon using a flexible fiber-optic scope. The exam is done under sedation and is quite painless. The doctor will take biopsies of your colon for a pathologist to evaluate.

Treatment of Ulcerative Colitis
There is no cure for ulcerative colitis. However, there are effective medical treatments used to suppress the inflammatory process. There are several types of medications used to treat ulcerative colitis. Anti-inflammatory drugs, such as Asacol, Colazal and Pentasa, are used to treat mild to moderate symptoms and to prevent relapse. Corticosteriods, such as Prednisone, are used to treat more severe cases; in general these should not be used as maintenance medications. There are several immune-suppressing medications such as Imuran and 6-MP that can be highly effective at suppressing the immune response, controlling symptoms and preventing relapse.

Occasionally severe attacks of ulcerative colitis may require hospitalization, bowel rest and intravenous treatment. In some cases surgery is required to remove the diseased portion of colon. Unlike Crohn’s disease, which can recur after surgery, ulcerative colitis is “cured” once the colon is removed.

In patients with long standing ulcerative colitis there is a higher risk of developing colon cancer. It is particularly important for these patients to undergo a regular and thorough screening for colon cancer.

Maintaining proper nutrition is important in the management of ulcerative colitis. While there is no evidence that any certain foods contribute to the disease, avoiding some may reduce your symptoms. Avoiding raw vegetables, high fiber and spicy foods and eating a more bland soft diet may cause less abdominal distress. Most doctors recommend a healthy, well balanced diet containing a variety of foods. Emotional stress can worsen almost any chronic illness. It is important to learn to deal with your emotional stressors in a healthy manner. There are support groups in most communities for people with Inflammatory Bowel Disease (IBD), you can find a list on the website link below.