Introduction
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that affects the innermost lining of the large intestine (colon) and rectum. It is characterized by inflammation and ulcers (sores) in the colon lining, leading to a variety of symptoms and potential complications. Ulcerative colitis is a lifelong condition with periods of remission (when symptoms are minimal or absent) and flare-ups (when symptoms worsen).
Causes
The exact cause of ulcerative colitis is not fully understood, but it is believed to involve a combination of genetic, environmental, and immune system factors. Possible contributing factors include:
- Genetics: People with a family history of ulcerative colitis are at higher risk.
- Immune system dysfunction: An abnormal immune response to bacteria or other substances in the colon.
- Environmental factors: Such as smoking, diet, and exposure to certain infections.
- Gut microbiome: Alterations in the balance of bacteria in the gut.
Symptoms
Symptoms of ulcerative colitis can vary depending on the severity and extent of the inflammation. Common symptoms include:
- Diarrhea (often bloody)
- Abdominal pain and cramping
- Rectal bleeding
- Urgency to have a bowel movement
- Inability to defecate despite the urge
- Weight loss
- Fatigue
- Fever
In some cases, ulcerative colitis can also cause symptoms outside the GI tract, such as joint pain, skin rashes, or eye inflammation.
Diagnosis
Diagnosis of ulcerative colitis involves a combination of:
- Medical history and physical examination
- Blood tests to look for signs of inflammation or infection
- Stool tests to rule out other causes of GI symptoms
- Colonoscopy or sigmoidoscopy with biopsy to examine the colon and rectum and take tissue samples for analysis
Treatment Options
There is no cure for ulcerative colitis, but treatment aims to reduce inflammation, relieve symptoms, prevent complications, and maintain remission. Treatment options include:
- Medications:
- Anti-inflammatory drugs (such as aminosalicylates or corticosteroids)
- Immunomodulators (such as azathioprine or methotrexate)
- Biologic therapies (such as TNF inhibitors, integrin inhibitors, or interleukin inhibitors)
- Janus kinase (JAK) inhibitors
- Surgery:
- In severe cases, surgery to remove the colon and rectum (proctocolectomy) may be necessary. This can be curative but requires the creation of an ileostomy or ileal pouch-anal anastomosis (J-pouch).
- Nutritional therapy:
- Special diets or supplements to address nutritional deficiencies
- Enteral or parenteral nutrition in severe cases
Prevention
There is no known way to prevent ulcerative colitis, but you can reduce your risk of flare-ups by:
- Following your healthcare provider’s recommendations for medication and follow-up
- Managing stress
- Eating a healthy diet
- Quitting smoking
When to Seek Medical Care
Seek medical attention if you experience:
- Persistent diarrhea or rectal bleeding
- Severe abdominal pain or cramping
- Unexplained weight loss
- Fever
- Symptoms that worsen or do not improve with self-care
Takeaway
Ulcerative colitis is a chronic inflammatory condition that affects the colon and rectum. While there is no cure, effective treatments are available to manage symptoms, prevent complications, and improve quality of life.