Conditions / Colitis/Ulcerative Colitis
Colitis/Ulcerative Colitis
Overview
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that causes long-lasting inflammation and sores (ulcers) in the lining of the colon and rectum. It primarily affects the large intestine, leading to symptoms such as abdominal pain, diarrhea (often with blood), fatigue, and weight loss. UC is characterized by periods of flare-ups followed by remission. Although the exact cause is unknown, it is believed to be the result of immune system dysfunction where the body attacks its own digestive tract. Ulcerative colitis can range from mild to severe, and it often requires lifelong management.
Types
Doctors often classify ulcerative colitis according to its location. Types of ulcerative colitis include:
• Ulcerative proctitis: Inflammation is confined to the area closest to the anus (rectum), and rectal bleeding may be the only sign of the disease. This form of ulcerative colitis tends to be the mildest.
• Proctosigmoiditis: Inflammation involves the rectum and sigmoid colon (lower end of the colon). Signs and symptoms include bloody diarrhea, abdominal cramps and pain, and an inability to move the bowels despite the urge to do so (tenesmus).
• Left-sided colitis: Inflammation extends from the rectum up through the sigmoid and descending colon. Signs and symptoms include bloody diarrhea, abdominal cramping and pain on the left side, and unintended weight loss.
• Pancolitis: Pancolitis often affects the entire colon and causes bouts of bloody diarrhea that may be severe, abdominal cramps and pain, fatigue, and significant weight loss.
• Acute severe ulcerative colitis: This rare form of colitis affects the entire colon and causes severe pain, profuse diarrhea, bleeding, fever, and inability to eat.
Symptoms
The most common areas affected by Crohn’s disease are the last part of the small intestine and the colon. Signs and symptoms of Crohn’s disease can range from mild to severe. They usually develop gradually, but sometimes they will come on suddenly, without warning. You may also have periods of time when you have no signs or symptoms (remission).
When the disease is active, signs and symptoms may include:
• Diarrhea
• Fever
• Fatigue
• Abdominal pain and cramping
• Blood in your stool
• Mouth sores
• Reduced appetite and weight loss
• Pain or drainage near or around the anus due to inflammation from a tunnel into the skin (fistula)
People with severe Crohn’s disease also may experience:
• Inflammation of skin, eyes and joints
• Inflammation of the liver or bile ducts
• Delayed growth or sexual development, in children
When to see a doctor
See a doctor if you experience:
• Persistent diarrhea, especially if it is bloody or lasts for several days.
• Severe abdominal pain or cramping that does not improve with over-the-counter medications.
• Unexplained weight loss or a significant loss of appetite.
• Signs of dehydration, including dizziness, dry mouth, and reduced urination.
• Rectal bleeding or blood in the stool.
• Fever lasting more than a few days or associated with abdominal pain.
Seek immediate medical attention if you experience:
• Severe abdominal pain, especially if it comes on suddenly and is not relieved by rest or over-the-counter medications.
• Symptoms of bowel obstruction, such as bloating, inability to pass gas, or constipation.
• Severe bleeding from the rectum, especially if the bleeding does not stop.
• Signs of dehydration, such as confusion, dizziness, or an unusually rapid heartbeat.
• Symptoms of toxic megacolon, including fever, abdominal distension, or rapid heart rate, can be life-threatening.
Causes
The exact cause of ulcerative colitis is unknown. One possible cause is an immune system malfunction. When your immune system tries to fight off an invading virus or bacterium, an abnormal immune response causes the immune system to attack the cells in the digestive tract, too. Heredity also seems to play a role in the fact that ulcerative colitis is more common in people who have family members with the disease. However, most people with ulcerative colitis don’t have this family history.
Risk Factors
Risk factors for ulcerative colitis include:
• Age: The disease most commonly develops in individuals between the ages of 15 and 30, though it can occur at any age.
• Family history: Having a close relative with IBD increases the likelihood of developing UC.
• Ethnicity: People of Jewish descent, particularly Ashkenazi Jews, have a higher risk of developing ulcerative colitis.
• Geography: UC is more common in Western countries, possibly due to dietary and environmental factors.
• Immune system issues: Conditions that affect the immune system, such as rheumatoid arthritis or psoriasis, can increase the likelihood of developing UC.
• Diet and lifestyle: While diet alone doesn’t cause UC, high-fat, low-fiber diets may contribute to disease development, and stress may worsen symptoms.
Complications
Possible complications of ulcerative colitis include:
• Severe bleeding
• A hole in the colon (perforated colon)
• Severe dehydration
• Liver disease (rare)
• Bone loss (osteoporosis)
• Inflammation of your skin, joints and eyes
• An increased risk of colon cancer
• A rapidly swelling colon (toxic megacolon)
• Increased risk of blood clots in veins and arteries
Medical Risk
Anti-inflammatory drugs are used to reduce inflammation but may cause side effects like headaches, nausea, or liver issues. Medications like corticosteroids or biologics suppress the immune system to reduce inflammation. These can increase the risk of infections and other side effects, including weight gain, mood changes, or weakened bones. Sometimes antibiotics are prescribed if infections occur, but overuse can disrupt the balance of gut bacteria, leading to complications.
Treatments