Ulcerative Colitis
Topic Overview
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Ulcerative colitis and Crohn's disease are the most common types of inflammatory bowel disease. Ulcerative colitis affects only the colon and rectum. Crohn’s can affect any part of the digestive tract. To learn more about Crohn’s disease, see the topic Crohn’s Disease.
What is ulcerative colitis?
Ulcerative colitis is a disease that causes inflammation and sores (ulcers) in the lining of the large intestine, or colon. It usually affects the lower section (sigmoid colon) and the rectum. But it can affect the entire colon. In general, the more of the colon that’s affected, the worse the symptoms will be.
See a picture of the colon
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Ulcerative colitis can affect people of any age, but most people who have it are diagnosed before the age of 30.
What causes ulcerative colitis?
Experts are not sure what causes ulcerative colitis. They think it might be caused by the immune system overreacting to normal bacteria in the digestive tract. Or other kinds of bacteria and viruses may cause the disease.
Ulcerative colitis is not caused by stress, as people thought in the past. But if you have ulcerative colitis, stress can make it worse.
You are more likely to get ulcerative colitis if other people in your family have it.
What are the symptoms?
The main symptoms are:
- Belly pain or cramps.
- Bloody diarrhea or an urgent need to have a bowel movement.
- Bleeding from the rectum.
Some people also may have a fever, may not feel hungry, and may lose weight. In severe cases, people may have diarrhea 10 to 20 times a day.
Ulcerative colitis can also cause other problems, such as joint pain, eye problems, or liver disease. But these symptoms are more common in people who have Crohn’s disease.
In most people, the symptoms come and go. Some people go for months or years without symptoms (remission). Then they will have a flare-up. About 5 to 10 out of 100 people with ulcerative colitis have symptoms all the time.1
Ulcerative colitis sometimes leads to more serious problems. It can cause scarring of the bile duct. This can lead to liver damage. In rare cases, severe disease causes the colon to swell to many times its normal size (toxic megacolon). This can be deadly and needs emergency treatment.
People who have ulcerative colitis for 8 years or longer have a greater chance of getting colon cancer.2 Talk to your doctor about your need for cancer screening. Screening tests help find cancer early, when it is easier to treat.
How is ulcerative colitis diagnosed?
To diagnose ulcerative colitis, doctors ask about the symptoms, do a physical exam, and do a number of tests. Testing can help the doctor rule out other problems that can cause similar symptoms, such as Crohn’s disease, irritable bowel syndrome, or diverticulitis.
Tests that may be done include:
- A colonoscopy. In this test, a doctor uses a thin, lighted tool to look at the inside of your entire colon. At the same time, the doctor may take a sample (biopsy) of the lining of the colon.
- A barium enema X-ray or an X-ray of your belly to show pictures of the colon.
- Blood tests, which are done to look for infection or inflammation.
- Stool sample testing to look for blood, infection, and white blood cells.
How is it treated?
Ulcerative colitis affects everyone differently. Your doctor will help you find treatments that reduce your symptoms and help you avoid new flare-ups.
If your symptoms are mild, you may only need to use over-the-counter medicines for diarrhea (such as Imodium A-D). Talk to your doctor before you take these medicines.
Doctors often prescribe medicines to reduce inflammation, such as:
- Steroid medicines. These can help reduce or stop symptoms. They are only used for short periods because they can cause side effects, such as bone thinning (osteoporosis).
- Aminosalicylates. These can be used to reduce or stop symptoms (sometimes at the same time as steroid medicines). After your symptoms are under control, you may take these medicines to help prevent flare-ups.
- Medicines that control the immune system (immunomodulators). You may need these if your disease is severe and aminosalicylates don't keep it from flaring up.
Some people find that certain foods make their symptoms worse. If this happens to you, it makes sense to not eat those foods. But be sure to eat a healthy, varied diet to keep your weight up and stay strong.
If you have severe symptoms and medicines don't help, you may need surgery to remove part or all of your colon. Removing the entire colon cures ulcerative colitis. It also prevents colon cancer. But it does have some serious risks. Still, most people who have surgery are glad they did.3, 4
How will ulcerative colitis affect your life?
Ulcerative colitis can be hard to live with. During a flare-up it may seem like you are always running to the bathroom. This can be embarrassing and can take a toll on how you feel about yourself. Not knowing when the disease will strike next can be stressful. Stress may actually make the problem worse.
If you are having a hard time, seek support from family, friends, or a counselor. Or look for an ulcerative colitis support group. It can be a big help to talk to others who are coping with this disease.
Frequently Asked Questions
Learning about ulcerative colitis:
Being diagnosed:
- What tests are used to diagnose ulcerative colitis?
- What happens during a medical history and physical exam?
- What other conditions have symptoms similar to ulcerative colitis?
- How does a colonoscopy help diagnose it?
- How does a stool analysis help diagnose it?
- How does a barium enema X-ray help diagnose it?
Getting treatment:
Ongoing concerns:
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| Author: | Monica Rhodes | Last Updated: November 3, 2008 |
| Medical Review: |
Kathleen Romito, MD - Family Medicine
Arvydas D. Vanagunas, MD - Gastroenterology |
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