You don’t want to ignore this type of chronic stomach distress.
Each year, 38,000 Americans are diagnosed with ulcerative colitis (UC), according to the Crohn’s and Colitis Foundation of America. UC is a type of inflammatory bowel disease that causes inflammation and ulcers in the large intestine (i.e. the colon).
Inflammation in the body is hard to picture and seems abstract, but it causes noticeable symptoms. The immune system mistakes the colon as a foreign invader and attacks, just like it would a flu virus or cancer cell. The inflammatory attacks on the colon affects the integrity of the colon lining and can lead to the following symptoms:
- Loose and bloody stool
- Frequent diarrhea
- Ulcers (open sores in the colon and rectal lining)
- Abdominal pain
- Weight loss
- Loss of appetite
- Delayed growth
Symptoms vary greatly among different individuals. “Some patients may have just mild symptoms … and go on for years,” says Sergey Khaitov, MD, surgeon at Mount Sinai Beth Israel. “Some patients may have such severe disease they may require emergency surgery within days after the disease started.”
One factor that may influence symptom presentation is what part of the colon is affected. UC might affect only the bottom of the colon, which causes primarily bowel symptoms, or it could affect the entire colon, which may cause weight loss and severe bleeding.
Like all inflammatory conditions, UC can cause inflammation in other parts of the body as well. People with UC are at an increased risk of developing inflammatory conditions in the joints, eyes, and skin, according to UpToDate from Wolters Kluwer.
Complications of Ulcerative Colitis
UC typically begins mild but progresses over time. “Ulcerative colitis may lead to a variety of complications, which are not always related directly to the intestines, but to the presence of chronic inflammation in the body,” says Dr. Khaitov.
If inflammation is unable to be controlled, complications may occur, such as:
Eye infections: This inflammation of the eye is called uveitis.
Skin inflammation: Those with UC are at an increased risk in developing inflammatory conditions of the skin, such as psoriasis.
Rectal bleeding and anemia: Ulcers, or open sores in the colon and rectum, leak mucus and blood through the stool. The problem with rectal bleeding is it could lead to anemia, or low red blood cell count.
Osteoporosis and osteopenia: Corticosteroids can help treat UC, but they may also affect bone density and can increase the risk of fractures.
Dehydration and malnutrition: Frequent diarrhea can increase the risk of dehydration, and inflammation in the colon can inhibit absorption of nutrients. Stomach pain and fear of symptoms may also cause a loss of appetite that increases the risk of malnutrition or unintended weight loss.
Toxic megacolon: Typically, UC only affects the innermost lining of the colon. However, if the inflammation spreads to deeper tissue layers, the colon becomes swollen and is no longer functional. Although rare, megacolon is a serious and life-threatening complication that requires surgery.
Colon cancer: “Sometimes, in rare situations, [UC] may lead to development of cancer in the colon and rectum,” says Dr. Khaitov.
Symptoms of UC occur in a pattern of flare-ups and remissions (a period of no symptoms). The good news is that each year, nearly half of people with UC are in remission, according to the Crohn’s and Colitis Foundation.
“Gastroenterologists will provide patients with medications to induce and maintain remission of the disease to keep the patient with no symptoms,” says Dr. Khaitov. Learn more about treatment of UC here.
Dr. Khaitov is a surgeon specializing in colon and rectal surgery at Mount Sinai Hospital.
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There is a great variability in
presentations in patients with
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Some patients may have just mild symptoms
of proctitis and go on for years.
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Some patients have such severe disease,
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they may require emergency surgery
within days after disease started.
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And there are patients who
have presentations in between.
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Ulcerative colitis most of the times
will affect large intestines,
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starting from the rectum upwards to other
portions of the intestinal tract within
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Common symptoms of ulcerative colitis
are abdominal pain associated
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with bloody diarrhea and sometimes
mucus bowel movements with urgency.
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Ulcerative colitis may lead
to weight loss, fatigue,
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growth retardation and lack of appetite.
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Symptoms may vary from very mild,
when patients have minimal or
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no symptoms at all, to very severe.
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For example, patients may develop
occasional diarrhea or blood in stool.
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While other patients will be very sick,
will have high fevers,
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extreme excruciating abdominal pain,
profuse bleeding from the rectum and
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may require emergency hospitalization or
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Ulcerative colitis may lead to a variety
of complications which are not always
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related directly to the intestines but
to presence of chronic inflammation
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in the bodies may lead to inflammation
of the joints, spine, eyes.
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Sometimes it may damage liver, and
sometimes in rare situation it may lead to
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development of cancer in the colon and
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Ulcerative colitis is characterized
by periods of flares and remissions.
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Some patients may go in remission and
have minimal or no symptoms for
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a very long time.
00:02:01,805 --> 00:02:04,598
Most patients will still
develop flares and
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will have intermittent
flare-ups of their symptoms.
00:02:08,178 --> 00:02:13,027
Gastroenterologists will provide
patient with medications to induce and
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maintain remission of the disease to
keep the patient with no symptoms.
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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.)
The facts about inflammatory bowel diseases. New York, NY: Crohn’s & Colitis Foundation. (Accessed on April 26, 2021 at http://www.crohnscolitisfoundation.org/assets/pdfs/updatedibdfactbook.pdf.)
Types of ulcerative colitis. New York, NY: Crohn’s & Colitis Foundation. (Accessed on April 26, 20218 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/.)