Ulcerative colitis is a type of inflammatory bowel disease and affected different parts of your gastrointestinal or GI tract.
Ulcerative colitis or UC occurs when the lining of the large intestine or the colon, rectum, or both has inflammation.
This inflammation is responsible for producing tiny sores or ulcers on the lining of your colon.
Moreover, this inflammation begins in your rectum and spreads upwards, and can also involve your entire colon.
It is important to note that the inflammation causes your bowel to move its contents rapidly and empty more frequently.
As the cells on the surface of the lining of the bowel die, ulcers form and can also beeld in some cases.
Additionally, they may also lead to a discharge of mucus and pus.
While this condition affects individuals of all ages, it often occurs during the age of 15 to 30 years, according to the American Gastroenterological Association.
Keep on reading to learn more about it.
Symptoms of Ulcerative Colitis
An important thing to keep in mind is that the seriousness of UC varies from one person to another.
Moreover, the symptoms can also change with time and may experience periods of mild symptoms or no symptoms at all.
This is Remission, however, symptoms can return and become severe.
This is Flareup.
Abdominal pain, increase in abdominal sounds, bloody stools, diarrhea, fever, rectal pain, weight loss, and malnutrition are common symptoms.
Additionally, the symptoms may be joint pain, joint swelling, nausea, and a decrease in appetite.
It can also cause skin problems, mouth sores, and eye inflammation.
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Causes of Ulcerative Colitis
Researchers are of the view that UC may be the result of an overactive immune system.
However, it is unclear why some immune systems respond by attacking the large intestines and others do not.
Factors that can play a role in the development of ulcerative colitis are:
Genes: You can inherit a gene from a parent and this increases your chances of having this disease.
Other immune disorders: If you have any other autoimmune disorder, then you have a chance of developing UC.
Environmental Factors: Certain environmental factors like bacteria, viruses, and antigens can trigger your immune system and cause this condition.
Types of Ulcerative Colitis
According to the parts of your GI tract, doctors characterizes UC as:
Ulcerative Potitis: In this condition, only your rectum is inflamed and is a mild form of UC.
Left-sided Colitis: This one causes inflammation in the area between splenic flexure or near the upper part of your colon where it bends and the last section of your colon.
The last section of your colon or distal colon includes the descending colon and sigmoid colon.
Left-sided colitis is also known as Distal Ulcerative Colitis.
Proctosigmoiditis: Proctosigmoiditis is a type or form of left-sided colitis and causes inflammation in the rectum and sigmoid colon.
Extensive Colitis: Extensive colitis or pancolitis causes inflammation in the entire colon and is the severe form of UC.
Diagnosis of Ulcerative Colitis
There are different tests that can help to diagnose this condition.
UC is just like other bowel diseases like Crohn’s disease, which is why your doctor will conduct a series of tests to rule out other conditions.
The following tests help to diagnose UC:
Blood Tests: Most often your doctor will use this test to diagnose this condition.
A CBC test looks for signs of anemia i.e. low red blood cell count.
Other tests indicate inflammation like a high level of C-reactive protein and a high sedimentation rate.
Your doctor may also order other specialized tests.
Stool Tests: Your doctor will examine your stool for certain inflammatory markers, blood, bacteria, and parasites.
CT Scan: A CT scan helps to create a specialized scam on of abdomen and pelvis.
Endoscopy: This consists of a flexible time to examine your stomach, esophagus, and small intestines.
Biopsy: A surgeon will remove a tissue sample from your colon and analyze it.
Flexible Sigmoidoscopy: It is a type of endoscopy and during this test, your doctor will insert a long tube into your rectum to examine it.
Moreover, it helps to examine the sigmoid colon and the descending colon.
Many doctors also refer it to as Sigmoidoscopy.
Colonoscopy: During this procedure, your doctor will insert a lighted scope into the rectum to examine the insides of your colon.
Also, it is a type of endoscopy.
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Ulcerative Colitis and Colonoscopy
Most often doctors use a colonoscopy to diagnose UC or determine the severity of this condition.
Before the procedure, your doctor will ask you to reduce the intake of solid foods and switch to a liquid-only diet.
Then you will fast for a period of time before the procedure.
Colonoscopy prep involves taking a laxative the evening before the procedure as it helps to eliminate any waste still in the colon and rectum.
This way your doctor can examine a clean colon more easily.
After the medications take effect, your doctor will insert a colonoscope into your anus.
This is a long and flexible device so it can easily move through your GI Tract.
It also has a camera attached to it, enabling your doctor to see inside the colon.
During this test, they will look for signs of inflammation and check for precancerous growth, Polyps.
Moreover, they can also perform a biopsy for further examination.
Thus, if your doctor diagnoses you with UC, they may conduct periodic colonoscopy to monitor inflammation, damage to the intestines, and healing progress.
Visiting a Doctor
If your doctor has made the diagnosis for UC, you may experience symptoms like:
- severe abdominal pain or cramping
- severe rectal bleeding
- chronic diarrhea
- high fever
- swelling in areas like skin or joints
- dehydration
Moreover, it is important to note that such symptoms are often associated with UC complications.
However, if you have not been diagnosed, consult your doctor in case you experience a number of symptoms.
They can help determine the cause and whether you have UC or another bowel condition.
Treatment Options
UC is a chronic condition and the goal of the treatment is to reduce the inflammation that causes your symptoms to prevent flare-ups.
Moreover, it helps to have long periods of remission.
Medications
The use of a certain type of medication depends on the specific situation, including its severity.
For mild symptoms, your doctor may prescribe a medication to reduce inflammation and swelling.
This can help alleviate many symptoms.
These types of medications include 5-aminosalicylates (5-ASA drugs) such as:
- mesalamine (Asacol HD, Lialda)
- sulfasalazine (Azulfidine)
- balsalazide (Colazal)
- olsalazine (Dipentum)
In some cases, individuals may need corticosteroids to help reduce inflammation, however, they have adverse effects.
Thus, doctors will try to limit their use and in case of infection, you may need antibiotics.
On the other hand, if you have mild to severe symptoms, you may need biologics.
These are made from antibodies and help block inflammation.
They can help prevent symptom flare-ups.
Effective options are:
Adalimumab (Humira), golimumab (Simponi), infliximab (Remicade), tofacitinib (Xeljanz), ustekinumab (Stelara), and vedolizumab (Entyvio).
They may also prescribe immunomodulatory to change the way your immune system works.
However, current guidelines do not recommend using these medications.
According to FDA, the Food and Drug Administration, the use of tofacitinib targets the cells responsible for inflammation.
It is one of the first oral medications approved for the long-term treatment of UC.
Hospitalization and Surgery
If your symptoms are severe, you will need immediate hospitalization to correct the effects of dehydration and loss of electrolytes due to diarrhea.
You may also need to replace blood and treat other complications.
Surgery
If you experience substantial blood loss, chronic and debilitating symptoms, perforation of your colon, or a severe blockage, then you may need surgery.
With the help of a CT scan or a colonoscopy, your doctor can determine these serious conditions.
Surgery involves removing your entire colon and rectum as well as creating new pathways for waste.
This can be out through a small opening in your abdominal wall.
To redirect waste through the wall, the surgeon will make a small opening in the wall.
The tip of the lower small intestine or ileum is then brought to the surface of the skin.
The waste will then drain through the opening into a bag.
In other types of surgery, your surgeon will remove the diseased part of your colon and rectum, however, retains the outer muscles of your rectum.
The surgeon will then attach the small intestine to the rectum to form a small pouch.
After this surgery, you will be able to pass stool through the rectum.
The bowel movements will be more frequent and watery than normal.
Natural Remedies for Ulcerative Colitis
Certain medications for UC can cause severe side effects.
If you do not tolerate traditional treatment, you can use certain natural remedies to treat this condition.
Some of the natural remedies are:
Boswellia: This herb is found in the resin underneath Boswellia serrata tree bark.
Research suggests that it can help stop some of the chemical reactions that cause inflammation.
Bromelain: This enzyme mixture is found in pineapples, however, it is also present as a supplement.
It can help ease the symptoms of UC and reduce flare-ups.
Turmeric: A golden yellow spice is chock-full of curcumin and is an antioxidant to help reduce inflammation.
Psyllium: It is a fiber supplement that helps to keep the bowel movement regular.
It can also help alleviate symptoms, prevent complications, and make discharge of waste easy.
However, many individuals with IBD can experience worsening abdominal cramping, gas, and bloating when they consume fiber.
Probiotics: Your intestines and stomach are home to billions of bacteria.
When the bacteria are healthy, your body is better able to ward off inflammation and symptoms of UC.
Thus, eating foods with probiotics or taking their supplements can help to boost the health of microbial flora in your gut.
It is important to keep in mind that natural remedies have not undergone clinical trials and are not endorsed by professional organizations.
Thus, consult your doctor before using them.
Many of these can be used in combination with other UC treatments.
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Diet for Ulcerative Colitis
There is no specific diet for UC, however, each individual reacts to food and drinks differently.
A few general rules may be:
A low-fat diet: It is not clear why it is effective, however, foods high in fact commonly cause diarrhea, especially for IBD.
Thus, eating a low-fat diet can help delay flare-ups and you can opt for olive oil and omega 3 acids.
Vitamin C: This vitamin may have a protective effect on your intestines and help them heal or recover faster after a flare-up.
Thus taking vitamin C can help and includes parsley, bell peppers, spinach, and berries.
Fiber: Fiber is the last thing you would want to eat during flare-ups.
During remission, however, it can help to stay regular and improve how easily you can eliminate waste products during bowel movements.
Moreover, making a food diary can help understand which food items affect you.
Tracking the food intake closely and how it makes you feel after hours can help.
Difference between UC and Crohn’s Disease
Uc and Crohn’s disease are the most common form of IBD, and both can result from an overactive immune system.
They also share symptoms like cramps, abdominal pain, diarrhea, and fatigue.
However, they have distinct differences, and understanding the key difference can help obtain a proper diagnosis.
Moreover, these two conditions affect different parts of the GI tract.
Crohn’s disease can affect any part of the GI tract, from your mouth to the anus, however, UC affects the large intestines and rectum.
Ulcerative Colitis: Is it Curable and Contagious?
There is no nonsurgical cure for UC, however, the treatment aims to extend the periods of remission and make flare-ups less severe.
If you have UC, curative surgery is a treatment option, and removing the entire large intestine will end the symptoms.
Moreover, it is not contagious.
Some causes of colitis or inflammation in the colon can be contagious and includes inflammation due to bacteria and viruses.
However. UC is not caused by anything that can be transmitted to another individual.
Ulcerative Colitis in Children
According to a study of IBD, 1 in 1299 children between the ages of 2 and 17 years of age are affected by the condition.
Moreover, Crohn’s disease is twice as common as UC and both are more likely to have IBD than girls.
A diagnosis is more likely to be made after 10 years of age for children with IBD.
UC symptoms in children are the same as that in older individuals.
They may experience bloody diarrhea, abdominal pain, and cramps.
Anemia due to blood loss, malnutrition from poor eating, and unexplained weight loss are other issues.
It can also affect your child significantly, especially if you do not get treatment and manage the symptoms.
It is important to note that the treatment for children is more limited because of possible complications.
However, the doctor may prescribe medication to help reduce inflammation and prevent immune system attacks on the colon.
Complications of UC
UC can increase your chances of developing colon cancer and the longer you have this condition, the higher your risk.
Because of this, your doctor will perform a colonoscopy and check for cancer when you receive a diagnosis.
Repeated scanning every 1 to 3 years is recommended, according to the American Cancer Society.
This can help lower your risk of colon cancer.
Other complications are thickening of the intestinal wall, bleeding, sepsis, severe dehydration, toxic megacolon, and rupture in your colon
Moreover, inflammation of your skin, joints, and eyes, ankylosing spondylitis, kidney stones, liver disease, are complications of UC.
If you do not get treatment, the complications of UC can worsen.
Preventing UC
There is no evidence that whether certain dietary changes can prevent the development of UC or not.
However, you may find that some foods and drinks can aggravate your symptoms when you have flare-ups.
Drinking small amounts of water, eating smaller meals, limiting your intake of high fiber foods, avoiding fatty foods, and lowering your intake of milk can help it.
Moreover, you can ask your doctor about taking multivitamins.
Outlook for People with Ulcerative Colitis
If you have UC, then you will have to follow the treatment plan throughout your life and your doctor will monitor the condition regularly.
The only cure for this condition is the removal of the entire colon and rectum, and your doctor will often begin with medications unless you have a severe complication. However, you may need surgery, but most do well with nonsurgical therapy and care.