About 900,000 Americans are affected by this inflammatory bowel disease.
Ulcerative colitis is a chronic inflammatory bowel disease (IBD). It causes irritation, swelling, and sores (ulcers) on the inner lining of the colon. Each year, 38,000 Americans are diagnosed with ulcerative colitis, according to the Crohn’s and Colitis Foundation of America.
Ulcerative colitis is the result of an abnormal immune response. Normally, the immune system fights foreign invaders that can make you sick. In people with IBD, however, the immune system thinks non-foreign substances, like food and healthy bacteria, are trying to invade. Because it thinks these generally non-harmful things passing through our intestines are foreign invaders, the body fights back by sending white blood cells to the intestinal lining. This causes chronic inflammation and ulcers, or, ulcerative colitis.
“The precise reasons for ulcerative colitis are unknown, but there are several theories behind disease development,” says Sergey Khaitov, MD, a surgeon specializing in colon and rectal surgery at Mount Sinai Hospital.
Ulcerative colitis is more common among people between the ages of 15 and 30, and after age 60. Genetic predisposition, an overactive immune system, or certain lifestyle habits may also contribute to the development of ulcerative colitis.
The Different Types of Ulcerative Colitis
There are four main types of ulcerative colitis: ulcerative proctitis, proctosigmoiditis, left-sided colitis, and pan-ulcerative colitis (or pancolitis). “This is a variable terminology that describes how much colon is involved,” says Dr. Khaitov.
- Ulcerative proctitis is when the inflammation occurs primarily in the rectum, located in the last few inches of the colon. About 30 percent of UC patients are diagnosed with ulcerative proctitis, according to the Crohn’s and Colitis Foundation.
- Proctosigmoiditis means the inflammation occurs in the rectum and right above the rectum in the sigmoid colon.
- Left-sided colitis is when the inflammation starts at the rectum and extends to the bend in the colon near the spleen, known as the splenic flexure.
- Pan-ulcerative colitis, or pancolitis, is when the inflammation affects the entire colon.
Diagnosing Ulcerative Colitis: Symptoms to Look For
Ulcerative colitis often begins gradually and becomes worse over time. Symptoms of ulcerative colitis depend on the type of ulcerative colitis a person has and the severity of their disease.
The combination of inflammation and ulceration that comes with ulcerative colitis can cause production of blood, pus, and mucus, as well as these symptoms:
- Loose and urgent bowel movements
- Persistent diarrhea
- Abdominal pain
- Bloody stools
“The symptoms are really the same whether someone is having a new presentation or a flare-up,” says Todd Linden, MD, a gastroenterologist in New York City. “As it becomes more severe, the pain becomes worse. People feel more tired, they lose their appetite, and sometimes people have a fever.”
How Ulcerative Colitis Is Treated
“Most patients who are diagnosed with ulcerative colitis will require consultation with a gastroenterologist, full colonoscopy to confirm the diagnosis, and they will need to initiate medical therapy for their disease,” says Dr. Khaitov.
The medications used to treat ulcerative colitis often suppress inflammation in the colon. These medications may include:
- Or biologics.
Along with following a treatment regimen, it’s also important to eat a well-balanced diet. No foods “cause” ulcerative colitis, but some foods may worsen symptoms. A healthy diet can help ease ulcerative colitis symptoms and promote healing.
Ulcerative colitis can’t be cured, but with the right treatment regimen and a healthy lifestyle, it can controlled. The treatment goal is to remain in remission (a period of no symptoms) for the long-term. Many people with ulcerative colitis maintain remission for years and years and are able to live active and productive lives.
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Ulcerative colitis is a chronic
inflammatory condition of the large
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intestines, which is characterize by
development of ulcerations in the internal
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lining of the large intestines.
00:00:15,605 --> 00:00:24,046
00:00:24,046 --> 00:00:26,540
Colon is part of intestinal tract.
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The main function of the large
intestines is to absorb water.
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By definition, ulcerative colitis
starts at the very end of the colon and
00:00:36,750 --> 00:00:41,520
can extend farther towards
the beginning by any different amount.
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Some people have just the rectum involved,
we call that ulcerative proctitis.
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Some people have the rectum and
then the next segment of colon involved,
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we call that proctosigmoiditis.
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The next group of people, it extends
farther up into the descending colon,
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and we call that left-sided colitis.
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In some people, the entire colon is
involved, and we call that pancolitis.
00:01:04,340 --> 00:01:08,530
So the symptoms are really
the same whether somebody's having
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a new presentation or a flareup.
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urgency, abdominal pain.
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As it become more severe,
the pain becomes worse.
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People feel more tired,
they lose their appetite.
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Sometimes people have a fever,
they have malaise, weakness.
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If you're bleeding,
you can become anemic and iron deficient.
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If you're having diarrhea all the time,
you could be losing protein, nutrients,
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electrolytes, fluid, become dehydrated,
everything that goes along with that.
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Ulcerative colitis may lead to
a variety of complications which are not
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always related directly to the intestines,
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to presence of chronic
inflammation in the body.
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Sometimes it may damage the liver,
and sometimes in rare
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situations it may lead to development
of cancer in the colon and rectum.
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Sometimes people have eye
manifestation, iritis, uveitis things like
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this, episcleritis, where the eyes become
red and painful and very irritated.
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Precise reasons for
ulcerative colitis are unknown.
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But there are several theories
behind the disease development and
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they include genetic predisposition
of certain individuals.
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The reaction to certain food we eat.
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Abnormal inflammation and protracted
inflammation when the inflammation
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continues beyond the infection or other
trigger already is gone from our body.
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Ulcerative colitis often presents
in patients who are young adults or
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also in patients who are 60 or older.
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Most patients who are diagnosed
with ulcerative colitis will
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full colonoscopy with biopsies
to confirm the diagnosis.
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And they will need to initiate
medical therapy for their disease.
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But primarily, the goal of treatment
these days is not just to deal with
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the symptoms but to really try to get
the underlying inflammation to be under
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control so that the patients don't have
symptoms that need to be treated anymore.
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Patient education: ulcerative colitis (beyond the basics). Waltham, MA: UpToDate, 2019. (Accessed on April 26, 2021 at https://www.uptodate.com/contents/ulcerative-colitis-beyond-the-basics.)
Types of ulcerative colitis. New York, NY: Crohn’s & Colitis Foundation. (Accessed on April 26, 2021 at http://www.crohnscolitisfoundation.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis/types-of-ulcerative-colitis.html.)
Ulcerative colitis. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed on April 26, 2021 at https://www.niddk.nih.gov/health-information/digestive-diseases/ulcerative-colitis.)
Ulcerative colitis. Washington, DC: MedlinePlus, U.S. National Library of Medicine. (Accessed on April 26, 2021 at https://medlineplus.gov/ulcerativecolitis.html.)What is ulcerative colitis? New York, NY: Crohn’s & Colitis Foundation. (Accessed on April 26, 2021 at http://www.crohnscolitisfoundation.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis/.)