Ulcerative Colitis

An inflammatory bowel disease (IBD) that provokes ulcers (sores) and inflammation in the digestive tract is called ulcerative colitis. This health condition negatively affects the large intestine’s lining (also known as the colon) and rectum. While ulcerative colitis symptoms appear over time, some people may experience sudden ones.

If you ignore this condition and do not treat it, you may experience life-threatening complications. However, there is no way to cure this condition, some new treatments can help to lessen the symptoms and bring long-term remission.

Symptoms

The symptoms often depend on the location and severity of the condition. Examples include:

  • Extreme tiredness (fatigue)
  • Rectal pain or bleeding
  • Abdominal cramps or pain
  • Diarrhea (sometimes with pus or blood)
  • Constipation
  • Weight loss
  • Fever
  • Grow delays (in children)

Approximately all patients who suffer from ulcerative colitis experience mild to moderate symptoms. In addition, some people have remission (the condition goes away for a long time).

What are The Types of Ulcerative Colitis?

Experts classify this colon condition according to its location. For example:

  • Ulcerative proctitis – The inflammation occurs in the region that is closer to the anus. One common symptom of this condition is rectal bleeding.
  • Proctosigmoiditis – In such cases, the inflammation happens in the rectum and lower end of the colon (sigmoid colon). Bloody diarrhea, abdominal cramps, and pain can occur in people with this condition.
  • Left-sided colitis – People with this colitis type experience inflammation from the rectum up through the sigmoid and other colon parts.
  • Pancolitis – This colitis type impacts the colon completely provoking severe bloody diarrhea, extreme weight loss, fatigue, and other symptoms.

When Should I See My Healthcare Professional?

If you experience any of the following symptoms, immediately seek medical attention. Examples include:

  • Abdominal pain
  • Bloody stools
  • Have diarrhea despite using over-the-counter medicines
  • Diarrhea awakens from sleep
  • Experience fever for more than 2 days

Commonly, this condition is not fatal but can cause serious complications if is not treated.

Causes

Some people think diet and stress are the primary ulcerative colitis causes. However, experts even do not know what triggers can provoke or worsen this condition. Another potential cause is the body’s defense (immune system) malfunction. For instance, the immune system does not attack invaders (such as viruses and bacteria) but its own digestive tract.

Moreover, it is considered that heredity plays an important role because most people with ulcerative colitis have a family history.

Risk Factors

Men and women have equal chances of getting ulcerative colitis. Check below some risk factors:

  • Family history – Your risk of developing ulcerative colitis increases if you have a close relative (including parents, siblings, or children).
  • Race or ethnicity – This colon disease occurs in white people more frequently than happens in any race.
  • Age – Older people are more prone to develop this disease.

Complications

  • Elevated risk of colon cancer
  • Osteoporosis (brittle bones)
  • Inflammation of the joints, eyes, or skin
  • Perforated colon
  • Swelling of the colon (toxic megacolon) that occurs suddenly
  • Severe dehydration or bleeding
  • Increased risk of blood clots in arteries or veins

Diagnosis

Physicians usually diagnose ulcerative colitis using endoscopic procedures and biopsy. However, other tests are done to exclude possible complications and other IBD forms (including Crohn’s disease). Check below some tests:

  • Blood and stool tests – These tests help to check for anemia, infections, or inflammation.
  • Colonoscopy – This test involves a thin tube with a camera on the end that helps your doctor to see the entire colon.
  • Flexible sigmoidoscopy – Some doctors prefer this test in case your rectum and colon are severely inflamed. It helps to see the sigmoid colon and rectum.

Imaging Tests

  • X-ray – Usually used to determine serious complications (such as megacolon or perforated colon)
  • CT scan – This test is used if your doctor suspects you have an ulcerative colitis complication.
  • Computed tomography (CT) enterography and magnetic resonance (MR) enterography – These are noninvasive tests used to rule out small intestine inflammation.

Treatment

The treatment for this condition commonly involves a combination of surgery and medicines. There are different medications that help in ulcerative colitis treatment but to find one that is best for you may need time. Additionally, some medicines may give you some severe adverse reactions. Discuss with your healthcare professional about risks and benefits before using them. Check below some examples:

Anti-inflammatory Medicines

  • 5-aminosalicylates (for example Sulfasalazine, Mesalamine, Balsalazide, Olsalazine, and others)
  • Corticosteroids (such as Budesonide and Prednisone)

Immune System Suppressors

The following medicines are usually prescribed by physicians to reduce inflammation. They work by suppressing the body’s defense, which begins the inflammatory process. Check below some of them:

  • Azathioprine and Mercaptopurine
  • Cyclosporine
  • Tofacitinib, Upadacitinib, and Ozanimod

Biologics

This medication category works by targeting proteins produced by the immune system. For example:

  • Infliximab, Adalimumab, and Golimumab
  • Vedolizumab
  • Ustekinumab

Other Medicines

Doctors may also prescribe you other medicines used to relieve the symptoms. For example:

  • Loperamide (used to lessen severe diarrhea cases)
  • Pain relievers (including Acetaminophen, Ibuprofen, Naproxen sodium, and Diclofenac sodium
  • Antispasmodics
  • Iron supplements

Surgery

The procedure that eliminates the whole colon and rectum is called proctocolectomy. Mostly, doctors perform a surgery called ileoanal anastomosis. It involves the removal of the colon and rectum. Thereafter, the surgeon will build a pouch from the end of the small intestine and you will need to wear a bag in which the stool is collected.

In case the pouch is not possible, the surgeon will make a permanent opening in the abdomen (ileal stoma), which the stool will pass through for collecting in a bag.

Colon Cancer

People with ulcerative colitis have an elevated risk of developing colon cancer. Thereby, regular checkups are recommended. How often you should go for a test will determine your doctor because it depends on the colitis location.

Frequently Asked Questions

What foods can trigger or worsen ulcerative colitis?

  • Carbonated drinks
  • Red or processed meat
  • Dairy products (such as mild and cheese)
  • Sugar alcohols
  • Insoluble fibers (including whole nuts and broccoli)
  • High-fat foods

Consult with your doctor for more details.

Can ulcerative colitis go away?

In some cases, people with this colitis type are in remission which may last for years. However, the symptoms can come back.

Are bananas good for ulcerative colitis?

Yes, bananas are considered low-residue foods that help to relieve the colitis symptoms. Ask your healthcare professional in case you have additional questions.

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