Definition
Ulcerative colitis is a chronic disease of the large intestine, in which the lining of the colon becomes inflamed and develops tiny open sores, or ulcers. This condition is caused by your immune system’s overactive response.
Crohn’s disease and ulcerative colitis affect as many as 1.6 million Americans, according to John Hopkins Medicine. Recent years have seen a steady increase in reported cases of IBD in Blacks.
Causes
The exact cause of ulcerative colitis is unknown, however, diet and stress are suspected culprits. Doctors know that these factors may aggravate but don’t cause ulcerative colitis.
One possible cause is an immune system malfunction. When your immune system tries to fight off an invading virus or bacterium, an abnormal immune response causes the immune system to attack the cells in the digestive tract, too.
Another possible cause is heredity. Ulcerative colitis is more common in people who have family members with the disease. However, most people with ulcerative colitis don’t have this family history.
Diagnosis
Endoscopic procedures with tissue biopsy are the only way to definitively diagnose ulcerative colitis. However, there are other types of tests that can help rule out complications or other forms of inflammatory bowel disease, such as Crohn’s disease.
Types of ulcerative colitis
Doctors typically classify ulcerative colitis according to its location. According to the Mayo Clinic types of ulcerative colitis include:
- Ulcerative proctitis. Inflammation is confined to the area closest to the anus (rectum), and rectal bleeding may be the only sign of the disease.
- Proctosigmoiditis. Inflammation involves the rectum and sigmoid colon — the lower end of the colon. Signs and symptoms include bloody diarrhea, abdominal cramps and pain, and an inability to move the bowels in spite of the urge to do so (tenesmus).
- Left-sided colitis. Inflammation extends from the rectum up through the sigmoid and descending colon. Signs and symptoms include bloody diarrhea, abdominal cramping and pain on the left side, and urgency to defecate.
- Pancolitis. This type often affects the entire colon and causes bouts of bloody diarrhea that may be severe, abdominal cramps and pain, fatigue, and significant weight loss.
Risk factors
Ulcerative colitis is equally as common in men as women. Risk factors may include:
- Age. Ulcerative colitis usually begins before the age of 30. However, it can occur at any age, and some people may not develop the disease until after age 60.
- Race or ethnicity. Although whites have the highest risk of the disease, it can occur in any race. If you’re of Ashkenazi Jewish descent, your risk is even higher.
- Family history. You’re at higher risk if you have a close relative, such as a parent, sibling or child, with the disease.
Complications
Ulcerative colitis can cause the following complications:
- Severe bleeding
- A hole in the colon (perforated colon)
- Severe dehydration
- Bone loss (osteoporosis)
- Inflammation of your skin, joints and eyes
- An increased risk of colon cancer
- A rapidly swelling colon (toxic megacolon)
- Increased risk of blood clots in veins and arteries
Treatment
Ulcerative colitis treatment usually involves either drug therapy or surgery.
There are several categories of drugs that may be effective in treating ulcerative colitis. The type you take will depend on the severity of your condition because some drugs may work well for some people, but not work for others. This means it may take time to find a medication that helps you.
In addition, because some drugs have serious side effects, you’ll need to weigh the benefits and risks of any treatment.
Lifestyle changes
It can be helpful to keep a food diary to keep track of what you’re eating, as well as how you feel. This will help you eliminate any foods that are causing you to flare.
Here are some general dietary suggestions from the Mayo Clinic that may help you manage your condition:
- Limit dairy products. Many people with inflammatory bowel disease find that problems such as diarrhea, abdominal pain and gas improve by limiting or eliminating dairy products. You may be lactose intolerant — that is, your body can’t digest the milk sugar (lactose) in dairy foods. Using an enzyme product such as Lactaid may help as well.
- Eat small meals. You may find that you feel better eating five or six small meals a day rather than two or three larger ones.
- Drink plenty of liquids. Try to drink plenty of liquids daily. Water is best. Alcohol and beverages that contain caffeine stimulate your intestines and can make diarrhea worse, while carbonated drinks frequently produce gas.
- Talk to a dietitian. If you begin to lose weight or your diet has become very limited, talk to a registered dietitian.
When to see a doctor
If you experience a persistent change in your bowel habits or if you experience any of the following, you should see a doctor:
- Abdominal pain
- Blood in your stool
- Ongoing diarrhea that doesn’t respond to over-the-counter medications
- Diarrhea that awakens you from sleep
- An unexplained fever lasting more than a day or two
- Although ulcerative colitis usually isn’t fatal, it’s a serious disease that, in some cases, may cause life-threatening complications.
