Ulcerative Colitis

Ulcerative Colitis

Ulcerative colitis is a chronic ulcerating condition of the colon, otherwise known as the large bowel.  It affects all age and ethnic groups, although most disease begins at a young age.  The disease can affect any portion of the large bowel, or just sections of the bowel.  The disease is also called by various other names depending on the location of involved colon, including pancolitis (entire colon involved) or proctitis (only rectum involved).  Ulcerative colitis is characterized by ulcers and inflammation affecting the colon lining.

What causes ulcerative colitis?

No one is yet certain what exactly causes ulcerative colitis.  There is likely a genetic predisposition to acquiring the disease.  Environmental factors such as diet and infections may contribute.  It is believed the body’s immune system targets the colon with antibodies, causing ulcers and inflammation to form.

What are the symptoms of ulcerative colitis?

Ulcerative colitis can cause life threatening disease or be very subtle.  Each patient develops his or her own set of symptoms, but there is not one particular set of problems that makes the diagnosis of ulcerative colitis.  Symptoms can develop slowly over months to years and symptoms vary based on the location within the colon of the ulcerations.  Symptoms include abdominal pain, diarrhea (both bloody and non-bloody), rectal pain, weakness, weight loss, rectal urgency, and passage of mucus or pus.  Anemia can be found on blood testing due to chronic blood loss from the colon.  Some patients also develop joint pain or skin rashes associated with ulcerative colitis.

How do I know if I have ulcerative colitis?

The diagnosis is often suspected from the symptoms.  Visualization of the colon via colonoscopy or flexible sigmoidoscopy is usually necessary to identify the location of ulcers and obtain tissue biopsies.  Sometimes barium tests of the small bowel or colon are helpful, and blood tests to look for anemia and inflammation may be requested by your physician.

What treatment is available?

Your physician will discuss with you treatment options.  Each patient is treated individually based on his or her specific pattern of disease.  Multiple treatments exist including steroids (prednisone or budesonide), 5-ASA compounds, immunomodulators and infliximab.  Although surgery is not recommended as first-line treatment for ulcerative colitis, removal of the colon is curative.  In cases where medications cannot control the disease or the patient’s life is being adversely affected by the disease, surgery can be a welcome option.  New techniques often allow for surgical pouch formation rather than a colostomy (a bag on the abdomen wall).

What are the possible complications of ulcerative colitis?

The dreaded complication of long-term ulcerative colitis is colon cancer.  The risk is significantly increased after having the disease for 8-10 years.  Your doctor will likely suggest routine colonoscopy screening of your colon due to this increased risk.

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