What is ulcerative colitis?

Ulcerative colitis is a chronic inflammatory condition of the digestive tract. It’s a form of Inflammatory Bowel Disease that involves inflammation of the inner lining of the colon and rectum. People with this condition alternate between flare-ups and periods of remission throughout their lives. While ulcerative colitis is a lifelong condition, it can often be managed with medication when taken as prescribed by our doctor.

What is a flare-up?

A flare-up is when the rectum and/or colon become inflamed. During a flare-up, people experience periods of increased ulcerative colitis symptoms, such as bloody diarrhea, rectal bleeding, abdominal pain or cramping, and an urgent need to go to the bathroom. Flare-ups can vary in duration and intensity.

Pathophysiology

The excess bacteria consume nutrients, including vitamin B12 and carbohydrates, leading to caloric deprivation and vitamin B12 deficiency. However, because the bacteria produce folate, this deficiency is rare. The bacteria deconjugate bile salts, causing failure of micelle formation and subsequent fat malabsorption. Severe bacterial overgrowth also damages the intestinal mucosa. Fat malabsorption and mucosal damage can produce diarrhea.

What is remission?

Remission is the time between flare-ups of ulcerative colitis when people experience few, mild, or no symptoms. Periods of remission vary in duration, anywhere from a matter of days to a number of years.

How common is ulcerative colitis?

It’s estimated that about one million Americans suffer from some form of IBD. About half of the people with IBD have ulcerative colitis, about half have Crohn’s disease.

What causes ulcerative colitis?

The causes of ulcerative colitis are unknown. Current research suggests that possible causes may involve, but are not limited to, heredity, infection, or the immune system. This condition affects people of all ages, but is often diagnosed during early adulthood. The medical research community recognizes that inflammatory bowel disease is more common in Caucasians, occurs with increased frequency in people of Jewish descent, and can run in families.

There’s no known cure for ulcerative colitis except for removal of the colon. However, research organizations, such as the Crohn’s & Colitis Foundation of America (CCFA), continue to research the cause of and the cure for UC and Crohn’s disease.

What are the symptoms of active ulcerative colitis?

Common symptoms of mild to moderate UC may include:

  • Rectal bleeding
  • Abdominal pain/cramping
  • Urgent need to go to the bathroom
  • Diarrhea

More severe ulcerative colitis symptoms may include:

  • Fever
  • Weight loss
  • Nausea
  • Vomiting

What is the long-term outlook for this condition?

Though ulcerative colitis can be unpredictable, medications can often provide people with a measure of control over this tough, persistent condition. Taking your medication as directed can play an important role in managing your symptoms.

How is ulcerative colitis diagnosed?

Usually, our doctor will perform all or some of the following:

  • Rule out disorders that may mimic the symptoms of UC
  • Complete a physical exam
  • Blood and stool tests
  • X-ray or an endoscopy

What medications are used to treat ulcerative colitis?

There are a number of medications prescribed to manage ulcerative colitis. These medications can come in different dosage forms, including tablets, capsules, suppositories, enemas, foams and infusions.

Some ulcerative colitis medications include:

  • 5-ASAs, or aminosalicylates, are medications such as mesalamine (sulfa-free) and sulfasalazine (contains sulfa)
  • Steroids, such as prednisone, and hydrocortisone
  • Biologics, such as infliximab

What is the risk of an ulcerative colitis patient developing colon cancer?

Not every person with UC will develop colon cancer. People with long-standing UC (i.e., more than 10 years) have a somewhat higher risk of developing colon cancer than the general population. Early detection and monitoring is extremely important and can greatly impact progression of colon cancer.

What is the role of surgery in the ulcerative colitis treatment?

Surgery may be an alternative for some who don’t respond to the intensive medial therapies available. Under these circumstances, the doctor may consider surgically removing portions of the colon and/or rectum. This procedure is called a colectomy.

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