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Ulcerative Colitis

Alternative names: Inflammatory Bowel Disease, Colitis

What is ulcerative colitis?
What are the signs of ulcerative colitis?
What causes ulcerative colitis?
How does my doctor tell if I have ulcerative colitis?
How is ulcerative colitis treated?

What is ulcerative colitis?

Ulcerative colitis is a chronic disorder that causes inflammation in the lining of the colon. Along with Crohn's disease, ulcerative colitis is an inflammatory bowel disease. While Crohn's disease can affect any area of the digestive (GI) tract, ulcerative colitis affects only the colon, the lower part of the large intestine.

What are the signs of ulcerative colitis?

Because ulcerative colitis is a chronic, recurring condition, symptoms can ease and reappear over time. About half of the people with ulcerative colitis suffer only mild symptoms. The most common symptoms include:

  • Frequent diarrhea, or loose bowel movements
  • Nausea, or feeling queasy
  • Loss of appetite
  • Minimal bleeding from the rectum
  • Weight loss
  • Feeling tired (fatigue)

Severe symptoms include:

  • Painful bowel movements
  • Frequent fevers
  • Stomach cramps
  • Significant bleeding from the rectum
  • A significant amount of blood in your bowel movements

The disease can also affect the joints, eyes, and liver. Patients with severe symptoms sometimes may need to go to the hospital to stop their diarrhea and bleeding.

What causes ulcerative colitis?

Doctors do not know why certain people get ulcerative colitis, but the risk of getting the disease seems greater if someone in your family already has the disease.

The disease usually begins in the rectal area and may eventually spread through the entire large intestine. Tiny sores (ulcers) form on the lining of the colon, where they bleed and cause diarrhea. The swelling and burning makes the colon empty frequently.

How does my doctor tell if I have ulcerative colitis?

The best test to diagnose ulcerative colitis is a colonoscopy, in which a doctor uses a thin, flexible tube to examine the colon and parts of the small intestine. The tube has a tiny video camera and a light mounted at its tip. The video camera transmits images to a television monitor, which allows your doctor to see inside your body. You will be sedated during the procedure, and will need to have someone drive you home. Plan to be at the hospital for about three hours.

Other blood or X-ray tests may be used to diagnose ulcerative colitis as well.

How is ulcerative colitis treated?

In most cases, ulcerative colitis can be controlled with medications. In the most severe cases, surgery may be required.

Non-surgical

Medications:

  • Aminosalicylates help reduce inflammation, and can treat mild to moderate symptoms
  • Corticosteroids suppress the immune system and are used to treat moderate to severe cases. These drugs are only used for short periods of time.
  • Immunomodulators also suppress the immune system, and can help reduce or remove the need for corticosteroids
  • Biologic therapy is used in moderate to severe cases of Crohn's disease and ulcerative colitis. Infliximab (Remicade) is one of the strong immune suppressants used in biologic therapy.

Surgery:

  • In severe cases, a doctor may consider surgery to remove the colon and rectum (colectomy). The surgeon may create an ileostomy, or an opening on the abdomen through which stools can be emptied into a pouch. In a newer type of surgery, the doctor connects the small intestine to the anus, which gives the patient more normal bowel function.
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