Ulcerative Colitis

Ulcerative colitis (UC) is a disease in which the lining of the colon (the large intestine) becomes inflamed and develops sores (ulcers), leading to bleeding and diarrhea. The inflammation almost always affects the rectum and lower part of the colon, but it can affect the entire colon.

Although ulcerative colitis cannot be cured, it can usually be controlled. Most people with ulcerative colitis are able to live active and productive lives. Controlling the disease usually means taking medications and seeing a healthcare provider on a regular basis.

ULCERATIVE COLITIS CAUSES

Ulcerative colitis is part of a group of conditions called inflammatory bowel diseases (IBD). Crohn's disease is another inflammatory bowel disease, although it can affect the entire digestive tract (mouth to anus). Inflammatory bowel disease is NOT the same as irritable bowel syndrome (IBS).

The cause of ulcerative colitis is not known. People who develop ulcerative colitis are thought to have an increased risk of the condition, which is passed down from family members. When a person with this inherited risk is exposed to a trigger (an illness or something in the environment), the immune system is activated. The immune system recognizes the lining of the colon as foreign and attacks it, leading to inflammation. This inflammation causes the lining of the colon to develop ulcers and bleed.

Genetics — Ulcerative colitis tends to run in families, suggesting that genetics have a role in this disease. About 10 to 25 percent of people with ulcerative colitis have a first-degree relative (either a sibling or parent) with inflammatory bowel disease (either ulcerative colitis or Crohn's disease).

Environment — Several environmental factors, such as infections, are thought to trigger ulcerative colitis in people who have a genetic susceptibility. However, no single factor has been proven to be the trigger.

ULCERATIVE COLITIS SYMPTOMS

The symptoms of ulcerative colitis can be mild, moderate, or severe, and can fluctuate over time.

Bowel symptoms — The most common symptoms of mild ulcerative colitis include:

• Intermittent rectal bleeding
• Mucus discharge from the rectum
• Mild diarrhea (defined as fewer than four stools per day)
• Mild, crampy abdominal pain
• Straining with bowel movements
• Bouts of constipation

In people with moderate to severe disease, the following symptoms can develop:

• Frequent, loose bloody stools (up to 10 or more per day)
• Low blood count (anemia)
• Abdominal pain, which can be severe
• Fever
• Weight loss

Non-bowel symptoms — For poorly understood reasons, people with ulcerative colitis can develop inflammation outside of the colon. Inflammation often affects large joints (hips, knees), causing swelling and pain, as well as the eyes, the skin, and, less commonly, the lungs.

These symptoms usually occur when ulcerative colitis symptoms are active (during a flare). However, inflammation can develop even when symptoms are quiet (in remission).

ULCERATIVE COLITIS DIAGNOSIS

Ulcerative colitis is usually diagnosed based upon your symptoms, a physical examination, and laboratory tests.

You will likely need a procedure that allows your doctor to look inside your colon, such as sigmoidoscopy or colonoscopy. These tests allow your doctor to take tissue samples from the colon, which can confirm ulcerative colitis and rule out other conditions that have similar symptoms, including Crohn's disease, diverticulitis, and certain infections.

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