If you have ulcerative colitis (UC), a type of inflammatory bowel disease, you’re not alone. According to the Centers for Disease Control and Prevention (CDC), UC affects as many as 246 of every 100,000 Americans. But what is UC and what can be done about it?
“Ulcerative colitis is a chronic, lifelong condition that affects the inner lining of your large intestine,” explains Nadir Adam, MD, general surgeon, Dignity Health Medical Group - Merced. “It usually starts in the rectal area and then moves upwards. It can occur at any age, but it’s most commonly diagnosed before 30.”
Symptoms
Symptoms of ulcerative colitis are related to how much and what parts of the intestine are affected. Symptoms may come and go. Often, symptoms will resolve for a period of time known as remission.
Symptoms typically start gradually and may include:
- Sudden urgency to have a bowel movement
- Abdominal pain and cramping
- Rectal pain
- Diarrhea
- Inability to move your bowels even if you feel the extreme need to do so
- Blood or pus in the stool
- Loss of appetite
- Weight loss
- Fatigue
- Fever
Children with ulcerative colitis may show signs of inadequate growth.
Diagnosis
If your doctor suspects you have UC, you may be sent for tests to confirm the diagnosis. These may include:
- Blood tests
- Stool samples
- Colonoscopy
- Biopsy of the bowel wall
- Barium enema
- X-ray
- Computerized tomography (CT) scan
- CT plus magnetic resonance (MR) enterography
Treatment Options
There is no cure for UC, however appropriate treatment may help reduce the symptoms and slow progression of the disease.
“Depending on the extent and severity of symptoms, we generally begin treatment with diet modifications and possibly medication to treat flare ups,” explains Dr. Adam. “If the symptoms persist or are severe, surgery may be considered.”
Diet: Different foods affect different people with UC in different ways. The general recommendations are to avoid foods that can cause gas or diarrhea, such as high fiber foods (beans, nuts, and seeds, for example). Eating several small meals a day rather than three large ones can also help the colon process the foods more slowly, as well. Fatty or greasy foods are also colitis triggers for some people. People with ulcerative colitis may also be lactose intolerant, so avoiding dairy products may reduce flare ups.
Medications: During a flare-up, your doctor may prescribe corticosteroids, such as prednisone, to reduce the inflammation in your colon. If you are dehydrated or severely malnourished, you may be admitted to the hospital for intravenous (IV) fluids and nutrition. If you have severe UC, your doctor may recommend long-term treatment with medications that affect the immune system, such as immunomodulators or biologic therapy. These treatments can have serious side effects, so they are generally reserved for people whose condition cannot be controlled by other measures.
Surgery: If your symptoms do not respond to medication, your doctor may recommend surgery to remove portions of the colon that are damaged to reduce the risk of severe bleeding, infection, a rupture in the wall, or cancer.
Are You at Risk for Ulcerative Colitis?
Scientists aren't sure what causes UC, but it may be hereditary. There are also theories that a person’s immune system can react to a trigger, causing the immune system to over react.
Living with Ulcerative Colitis
“Having unexpected bouts of abdominal pain and diarrhea can affect your day to day quality of life,” says Dr. Adam. “Planning ahead and talking to your loved ones and close friends about your symptoms can help.”
Discuss your symptoms with close family and friends, so they understand why you may have to suddenly cancel plans or leave the room. Check your surroundings when you’re in a new place to find the bathrooms before you need one. These two steps can help to make living with UC a bit easier.
Nadir Adam, MD, is a general surgeon with Dignity Health Medical Group - Merced and performs open and laparoscopic procedures involving the colon and rectum. See his complete profile here.
