What is Ulcerative Colitis?
Ulcerative colitis is a type of chronic inflammatory bowel disease (IBD) that causes ulcers to form in the digestive tract. This condition affects the innermost lining of the large intestine and rectum. The inflammation in ulcerative colitis usually starts in the rectum and may spread to parts of, or the entire, colon.
Symptoms of ulcerative colitis usually develop over time, and may include:
- Loose and urgent bowel movements.
- Abdominal cramping or pain.
- Blood stools.
- Loss of appetite.
- Unintended weight loss.
While it is not known what causes ulcerative colitis, it may include many factors including an immune system malfunction, heredity and environment. This condition can occur at any age, though most patients are diagnosed in their mid-30s. Your chances of getting this condition may be slightly higher if you have a family member with IBD, eat a high-fat diet or use NSAIDS like Advil or Motrin frequently.
How is Ulcerative Colitis Diagnosed?
If you or your doctor suspects ulcerative colitis, he or she will conduct a physical exam, as well as ask you questions regarding your health history and symptoms. Your doctor may also recommend some diagnostic testing which may include blood or stool tests, colonoscopy, X-ray, CT scan and more. In cases where ulcerative colitis is present, your doctor will diagnose you depending on the type of colitis.
Ulcerative colitis is often classified according to its location and includes:
Bowel inflammation occurs only in the rectum. Common symptoms include rectal pain, rectal bleeding and urgent bowel movements.
Inflammation is present in the rectum and sigmoid colon. Symptoms consist of bloody diarrhea, abdominal pain and cramping and a feeling of needing to pass stool even if the bowels are empty.
Inflammation begins in the rectum and extends into the sigmoid and descending colon. Common symptoms include bloody diarrhea, pain on the left side of the abdomen, loss of appetite and weight loss.
Inflammation affects the entire colon. Symptoms include bloody diarrhea, abdominal pain and cramps, fatigue and weight loss.
Treatment Options for Ulcerative Colitis
While there is no cure for ulcerative colitis, there are treatments to help patients regulate their immune systems and manage symptoms. The treatment option that is right for you will depend on the severity of your symptoms, your health history, your age and your preference. Treatment options may include:
Antibiotics can be prescribed to help prevent or treat infections.
These steroid medications can help to ease inflammation in the body, and may include prednisone or budesonide. They are not recommended for long-term use, as they may cause unwanted side effects.
Aminosalicylates, also known as 5-ASAS are anti-inflammatory drugs that contain 5-aminosalicylic acid. They are often the first step in the treatment of ulcerative colitis and include sulfasalazine, mesalamine and balsalazide, among others.
Biologic therapies modify the immune system to stop it from causing ongoing inflammation. Examples include adalimumab (Humira), infliximab (Remicade) and vedolizumab (Entyvio), among many more.
These drugs work by suppressing the immune system to reduce inflammation. Examples may include azathioprine (Imuran®) and cyclosporine.
For individuals who do not respond to diet and lifestyle changes, drug therapy or other treatments, surgery may be an effective option. Surgery involves removing the entire colon and rectum. In most cases, this will call for a procedure known as J-pouch surgery, which will eliminate the need to wear an ostomy bag (a bag to collect stool). However, in some cases, this procedure is not possible, and a permanent ostomy bag may be required.
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