Gastrointestinal Diseases

Listen

Ulcerative Colitis

Summary:

Ulcerative colitis (UC) is a chronic disease that affects all age groups; but is most common between 15 and 30 years old.
Ulcerative colitis affects the innermost lining of the large intestine (colon) and rectum.
UC symptoms usually develop gradually over time (not suddenly).
Symptoms can be treated with drugs that control inflammation; it can be treated by means of a surgery.
The disease is unpreventable to date; however, there are tips that can be followed to ease the symptoms.

Overview:

Ulcerative colitis is a chronic disease affecting the innermost lining of the large intestine (colon and rectum); causing inflammation or swelling and sores, called ulcers. It can occur at any age; but is most common between 15 and 30 years old.

Colon:

Colon is part of the large intestine, located below the abdomen and occupying a large area of the abdomen. It also extends from the bottom of the rib cage to the pelvic area horizontally. It is the last part of the large intestine, where the colon contains four parts:

Sigmoid colon (adjacent to the anal area)
Descending colon
Transverse colon
Ascending colon

Names:

Ulcerative colitis (UC)

Types:

Often categorized by location, ulcerative colitis includes:

Ulcerative proctitis: Inflammation is limited to the area closest to the anus, where bleeding is the sign of this type.
Sigmoiditis: Involves the lower end of the colon.
Left-sided ulcerative colitis: Inflammation extends from the rectum to the sigmoid colon and descending colon.
Ulcerative colitis: Inflammation that most likely affects the entire colon, causing bouts of bloody diarrhea that may be severe.
Severe acute ulcerative colitis (rare): This type affects the entire colon and causes severe pain, severe diarrhea and bleeding, with the inability to eat.

Cause:

The exact cause of the UC is unknown; it was previously suspected to be linked to diet and stress; but these factors may aggravate the disease, but not stimulate its incidence in the first place. There are also a number of factors likely to play a role in the disease development, such as:

Hereditary factors: Genes may increase the risk of suffering colon problems.
Overactive bowel immune system: An abnormal immune response in the intestine.

Risk Factors:

Age, with the risk usually higher under 30 years old
Family history
Overconsumption of milk and dairy products
Taking antacids (steroids)
Smoking

Symptoms:

Symptoms usually appear gradually over time and not suddenly. Most people with this disease suffer mild to moderate symptoms, including:

Diarrhea with blood or pus
Abdominal pain
Fatigue and exhaustion
Nausea or loss of appetite
Weight loss
Fever
Anemia

Symptoms can vary from person to person, depending on the severity of the inflammation and its location.

When to see a doctor?

When observing an ongoing change in the bowel routine, or when detecting any of the following signs:

Blood in the stool;
Persistent diarrhea that does not respond to medications;
Inexplicable fever for more than one or two days.

Complications:

Rectal bleeding
Colon hypertrophy
Osteoporosis
Infections in the eyes, skin and joints
Increased risk of colon cancer

Diagnosis:

Medical history
Family history
Clinical examination
Laboratory tests: Blood or urine tests
Other tests, including: Colonoscopy, X-ray, CT scan.

Treatment:

Treatment depends on the severity of the conditions and symptoms, in addition to the patient's health condition. Treatment is either pharmacological or surgical; where pharmacological treatment involves:

Anti-inflammatory drugs
Corticosteroids
Immune system inhibitors

Surgery often involves removing the entire colon and rectum, with surgery to expel waste naturally. Sometimes, a permanent opening is made in the abdomen through which stool may be passed and collected in an accessory bag.

Prevention:

There is still no way to prevent the disease; however, there are tips that can be followed to ease the symptoms.

Guidelines for People with Ulcerative Colitis:

Seek medical advice before using antibiotics, painkillers, anti-diarrheal medicines or iron supplements; as the severity of the disease may increase.
Avoid caffeine and foods that increase the severity of the disease (e.g. foods rich in fiber and spicy foods).
Maintain the diet that has been prescribed by your doctor.
Divide meals into five or six small meals.
Drink plenty of fluids to prevent dehydration.
Do not stop eating certain food groups without talking to your doctor.
Manage stress levels by physical activity, breathing exercises and relaxing.
Make sure to control the symptoms before pregnancy.
Quit smoking.

FAQs:

Can a patient with ulcerative colitis become pregnant?

A woman's fertility has nothing to do with her readiness to get pregnant when having ulcerative colitis, but in case of complications of the disease and the patient undergoes surgical treatment, it was found that fertility rates in women decreased by 26% after surgery.

Does taking vitamins on an empty stomach cause ulcerative colitis?

They are not linked to one another; because the infection is usually in the lower part of the intestine, and vitamins are absorbed by the upper part.

Myths & Truths:

The disease can be treated by changing the diet.

Truth: A person’s diet is one of the factors causing UC. Thus, changing the diet plays a role in prevention.

Ulcerative colitis is Crohn's disease.

Truth: Crohn's disease affects the entire gastrointestinal tract from the mouth to the anus, and the symptoms are usually pain, involving all the intestines, unlike ulcerative colon which affects the lower part, and thus pain is only felt in the lower abdomen.

Ulcerative colitis means cancer.

Truth: Ulcerative colitis is different from cancer in many ways. Ulcerative colitis is a normal inflammation of the tissues of the inner lining of the intestine. There is no accelerated cell proliferation and a change in the nature and division of cells as in cancer.

Health Promotion and Clinical Education General Department

For inquiries, contact us by email.