Ulcerative Colitis: Symptoms, Causes and Treatment

Ulcerative colitis is an inflammatory condition that affects the colon, a part of the large intestine, and the rectum. The inflammation is usually found on the innermost lining of the colon and rectum and develops slowly, often as a chronic rather than an acute condition. It is a type of Inflammatory Bowel Disease or IBD.

About ulcerative colitis

Ulcerative colitis is the inflammation of the colon lining that occurs in about 9 to 20 cases of every 1,00,000 persons. It has a higher prevalence of occurrence in adults.

Types of ulcerative colitis

There are five types of ulcerative colitis based on their location. These are:

• Ulcerative proctitis: This type of ulcerative colitis is confined to an area near the anus and rectum, and one of the early signs of this type is bleeding. This type of colitis is considered to be a milder form of the disease.
• Proctosigmoiditis: In this type the rectum and the sigmoid colon are inflamed, and the patient shows symptoms like cramps in the abdomen, bloody diarrhea, and the inability to pass a motion despite the urge to do so.
• Left-sided colitis: This ulcerative colitis extends from the rectum to the sigmoid and the descending colon. The symptoms are similar to those in proctosigmoiditis, and the patient may also experience unexplained weight loss.
• Pancolitis: This type of colitis affects the colon entirely and results in bloody diarrhea, cramps in the abdomen, pain, and severe fatigue.
• Acute severe ulcerative colitis: This is an acute form that affects the entire colon and results in severe symptoms such as diarrhea, fatigue, abdominal cramps, and fever. Many patients with this condition are often unable to eat due to nausea.

Also Read About: Solitary Rectal Ulcer Syndrome

What are the symptoms of ulcerative colitis?

Depending upon which part of the colon is affected by this condition, the symptoms can vary widely. Some common symptoms include:

• Abdominal cramps
• Bloody diarrhea
• Abdominal pain
• Rectal pain with or without bleeding
• Urge to defecate frequently
• Inability to defecate
• Unexplained weight loss
• Fever
• Fatigue

When ulcerative colitis occurs in children, they are deficient in normal growth. Most patients with this condition have mild to moderate symptoms, and these symptoms are often interspersed with a period of remission when the patient is completely asymptomatic.

When to see the doctor?

Most people often do not realize that they suffer from the early stages of ulcerative colitis until they see one or more symptoms. If you notice the following symptoms and signs, you must visit your doctor immediately:

• Diarrhea that wakes you from sleep due to its urgency and uncontrollable nature
• Diarrhea that does not respond to OTC (Over The Counter) medications
• Severe abdominal cramps
• Blood in your stool
• Unexplained weight loss and fever along with bloody stools

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What causes ulcerative colitis?

There is no single cause of ulcerative colitis, and what causes it has still not been found. There is a general view that stress, diet, and lifestyle are aggravating factors of ulcerative colitis. However, a possible cause of ulcerative colitis is an immune system malfunction, wherein the body’s immune system destroys the body’s own cells while trying to fight the microbes.

What is your risk of developing ulcerative colitis?

While there are no specific causes of ulcerative colitis, there are a few risk factors that include:

• Age: This condition is more common in adults than in children. It is said to begin around 30 years of age. However, it can occur at any age.
• Family history: Individuals who have a history of this disease in their family are at a higher risk of developing this condition.
• Race: Though this condition can affect any race or ethnicity, ulcerative colitis is more common in the Ashkenazi Jews.

Complications

When not treated in time, ulcerative colitis can result in complications such as:

• Excessive bleeding
• Dehydration
• Perforation in the colon
• Rapid swelling of the  colon[ a condition called toxic megacolon]
• Bone, eye, and skin inflammation
• Increased risk of liver disease
• Increased risk of cancer

How is it treated?

Depending upon the symptoms and extent of the disease, ulcerative colitis can be treated medically or surgically. The type of drugs chosen depends upon the location of ulcerative colitis and its extent. Some commonly used drugs for treating this condition include:

• Corticosteroids
• Immunomodulators
• 5-ASA
• Biologics
• Other medications for symptomatic relief

The best and most successful treatment for ulcerative colitis is surgery, as it can completely eliminate the condition. However,  this usually means removing your entire colon and rectum (proctocolectomy).

This surgery usually involves a procedure called ileal pouch-anal anastomosis. This is a preferred method as it eliminates the need to wear a bag to collect stool for the patient. However, in cases where a pouch is not possible, the surgeon will create a permanent opening in the abdomen (called an ileal stoma). It is through this opening that your stool is passed for collection in an attached bag.

Lifestyle Changes for Management of Ulcerative Colitis

• Reduce or avoid dairy products. 
• Stay clear of other problem foods: You must avoid spicy foods, alcohol, and caffeine as they are notorious for symptom flare-ups in ulcerative colitis cases.
• Avoid large portions of meals. Eat small meals instead: To manage your symptoms, you may find it helpful to eat five or six small meals every day instead of two or three large ones.
• Keep yourself hydrated, always! : Another useful lifestyle tip to keep your signs and symptoms of ulcerative colitis in check is to drink plenty of fluids every day. Water is the best. Avoid alcohol and caffeine beverages as they tend to irritate your intestinal lining and stimulate your intestines, thereby making your diarrhea worse. Avoid carbonated drinks as they are known to produce gas. Avoid eating outside food.

Another factor that triggers flare-ups of ulcerative colitis is stress. Here is how you can keep this trigger factor in check:-

• Mild to Moderate Exercise Daily: It has been well proven that getting your daily dose of exercise helps produce endorphins, the happy hormones, that reduce your stress levels, relieve depression and regularize your bowel function.
• Biofeedback: There is a stress-reduction method that helps you reduce your muscle tension and reduce your heart rate with the help of an inbuilt biofeedback machine.
• Practice Meditation and Relaxation: Yoga, meditation, and breathing exercises are a great way to cope with stress and provide instant relaxation to your mind and body.

One thing that you must understand is that there is no cure for ulcerative colitis, and the best and only way to permanently get rid of the condition is by removing the colon and/or the rectum.

If you are experiencing any symptoms or observe any signs that may indicate ulcerative colitis, visit our specialists at Apollo Hospitals at the earliest.