Understanding Ulcerative Colitis

Ulcerative colitis is a form of inflammatory bowel disease, or IBD. It’s estimated that around 1.3 percent of the population have some form of IBD. This means that approximately 3 million adults in the U.S. suffer from either ulcerative colitis or Crohn’s disease. Of the two conditions, ulcerative colitis is somewhat rarer, affecting approximately 700,000 people across the country. Although anyone can have IBD, it has been noted that individuals living in poverty appear more likely to develop these conditions. Ulcerative colitis can happen in childhood, but most are diagnosed in their 20s or 30s.

Inflammatory bowel disease is a chronic condition that is still being studied and understood. Although there is no definitive cure for ulcerative colitis, a variety of treatment options and lifestyle adaptations can help to reduce the prevalence and severity of symptoms.

Tashatuvango / Shutterstock.com

What is Ulcerative Colitis?

Ulcerative colitis is an autoimmune condition characterized by chronic inflammation in the large intestine, or colon. Its distinguishing characteristic is the presence of ulcers on the lining and surface of the bowel. Some people with ulcerative colitis may also experience inflammation in other areas of the body, including the skin and joints.

Both ulcerative colitis and Crohn’s disease are forms of inflammatory bowel disease, and they share many similar symptoms. The key difference between the two is the location and pattern of inflammation. Crohn’s disease may affect any part of the gastrointestinal tract, with ulcers appearing in patches. Ulcerative colitis affects only the rectum and colon and appears in a continuous pattern of ulcers and inflammation.

Are You at Risk?

As with many autoimmune disorders, there appears to be a strong genetic link in the development of ulcerative colitis: Up to 20 percent of people with IBD have a blood relative who also has IBD.

The condition affects both men and women equally. Symptoms often emerge in an individual’s late teens or during young adulthood, with a diagnosis often being given by age 30. However, it is possible to develop IBD symptoms later in life.

Symptoms and Causes

The symptoms of ulcerative colitis may vary from one patient to the next depending on the severity of inflammation. Although it is a chronic condition, an individual may not experience symptoms all the time. Instead, symptoms may come and go as a result of intermittent “flare ups” and periods of remission. Some common symptoms include:

  • Abdominal pain and discomfort
  • The presence of blood or pus in the stool
  • Fever
  • Weight loss and reduced appetite
  • Frequent diarrhea
  • Fatigue
  • A sudden urge to move your bowels, called tenesmus

In severe cases, anemia may develop due to blood loss from the irritated and openly bleeding ulcers in the bowel.

Ulcerative colitis can become a progressive disease, meaning that symptoms may worsen over time. This is why identifying IBD and taking steps to manage the symptoms is important. Left untreated, IBD can lead to serious or life-threatening complications including a ruptured bowel, profuse bleeding and infection.

What Causes Ulcerative Colitis?

The exact cause of IBD is still being researched, but it’s thought that a combination of hereditary, immune system, and environmental factors work together to create ulcerative colitis. In other words, people may inherit a predisposition toward IBD but may not experience symptoms if outside factors are not triggered.

What is commonly seen is that an outside environmental factor, such as a bacterial or viral agent, may trigger an abnormal immune system response. The resulting inflammation can in turn become chronic or recurring.

Common Treatment Options

Ulcerative colitis is diagnosed primarily through ruling out other conditions that could be responsible for the apparent symptoms. Other diagnostic techniques, including a colonoscopy or flexible sigmoidoscopy, can help to visibly identify areas of inflammation and open ulceration.

Once a diagnosis has been given, the treatment options will depend in part on the severity of symptoms. A variety of drug therapies are available to help with reducing inflammation and limiting the immune system response. These include:

  • Anti-inflammatory drugs taken orally or as a suppository
  • Corticosteroids, which are usually given for short-term relief alongside other more long-lasting treatments
  • Immunosuppressants, which prevent the immune system from causing inflammation

These treatments may be supplemented as necessary with antibiotics, anti-diarrheal medication and NSAID pain relievers. For people with severe bleeding, iron supplements may be prescribed as well to help with symptoms of anemia. Severe cases may require surgical intervention.

Alternative Treatments

Alternative medicine and lifestyle changes may play a role in helping IBD patients enjoy greater quality of life. For many people, ulcerative colitis episodes occur more frequently in response to certain environmental triggers, especially dietary changes. Identifying and avoiding your specific trigger foods can help with managing symptoms and preventing flare-ups.

A variety of herbal medicines have been used for managing IBD symptoms as well, although any herbal treatment should be discussed with your doctor to prevent potentially dangerous contraindications. Potentially effective herbal remedies include aloe vera, wheat grass, frankincense, slippery elm and turmeric.

Life with Ulcerative Colitis

The prognosis for a person with IBD will depend in part on that person’s overall health and the severity of the disease. In general, however, the outlook is positive for those who actively manage their symptoms.

People with IBD are at a higher risk of developing some cancers, especially colon cancer, and thus should be screened more often for these risks. Other common IBD complications, including anemia and systemic infection, should be watched carefully and treated as soon as they develop.

Living with ulcerative colitis may require some lifestyle changes, both in terms of diet and planning the day around access to a bathroom. Monitoring triggers and avoiding them will help to alleviate some symptom flare-ups. Experimenting with medication until the right combination is found may also help to ensure the best long-term results. For many people, treatment can help to send the disease into remission.