Ulcerative Colitis - Causes, Symptoms, Diagnosis & Treatment

Ulcerative Colitis

Dr.Santosh D Hajare profile Authored by Dr.Santosh D Hajare on 26 Aug 2014 - 17:32.

Ulcerative colitis refers to a chronic condition causing progressive inflammation of the inner linings on digestive tract (especially large intestine and colon). Usually, inflammation begins in the rectum and then deeply spreads into other parts of the digestive tract. It is characterized by on and off flare-ups and remission. Although it may affect anybody at any age, it is believed to affect more commonly to the people between 15 to 30 years old, equally to men and women. The severity of the disease may vary from mild to severe, depending upon the affected portion. Surprisingly, it does not affect small intestine, stomach and esophagus.

Types of ulcerative colitis:

Based on the portion of the digestive tract affected, ulcerative colitis are classified as:

  • Ulcerative proctitis – Its mild inflammation of rectum and its surrounding area
  • Proctosigmoiditis – Inflammation of rectum and lower part of colon
  • Left-sided colitis – Inflammation spread from the rectum to upper left part of the stomach (sigmoid region)
  • Pancolitis –  Affects the entire colon
  • Fulminant colitis – It's rare and severely affects entire colon

Exact cause and/or triggering factors of ulcerative colitis are quite unclear. Some factors that may play a role in ulcerative colitis may include:

  • Stress - Initially, it was believed to be linked with stress. However, according to recent research, instead of a triggering factor, stress may play a role in the progression of the symptoms.
  • Body’s immune response to foreign body or autoimmune response.
  • Family history of ulcerative colitis.
  • A viral and/or bacterial infection.

Symptoms of ulcerative colitis may vary based on affected part. Commonly presented symptoms may include:

Ulcerative proctitis

  • Rectal bleeding
  • Mild rectal pain
  • Feeling of urgency

Proctosigmoiditis

  • Blood in the stool
  • Abdominal cramps
  • Restricted bowel movement

Left-sided colitis

  • Pain in the upper left abdomen
  • Bloody diarrhea
  • Sudden weight loss

Pancolitis

  • Severe loss of blood in stool
  • Abdominal pain
  • Fatigue
  • Significant weight loss

Fluminant colitis

  • Severe pain
  • Colon rupture
  • Rapid expansion of colon

The doctor may perform the following tests and procedures to confirm a diagnosis of ulcerative colitis:

  • Blood examinations: To check for the traces of an infection based on the presence of specific antibody’s produced against foreign pathogens.
  • Stool examination: To trace out the presence of white blood cells (WBCs) those are often found in stool if colon or digestive tract is inflamed or damaged.  It also helps to detect the infection of various pathogens, including bacteria, virus or parasites.
  • Biopsy: To detect the signs of inflammation. A suspected tissue is scraped out and then examined under the microscope.
  • Colonoscopy: To view the clear image of digestive tract this helps the doctor to look at the inflammation signs.
  • Flexible sigmoidoscopy: To take out a clear image of the severely damaged colon.
  • Barium enema test: To assess the large intestine with the help of x-ray. It is a rare test which uses barium to coat the linings of the digestive tract.
  • X-ray: To observe any signs of perforation or inflammation.
  • CT scans: To trace out the extent of an inflammation and the severity.

Following factors may increase the risk of developing an ulcerative colitis:

  • Being under 30 years old.
  • Belonging to the white race.
  • Being ethnic of Ashkenazi Jewish descent.
  • Having ulcerative colitis running in the family for generations.
  • Excess use of specific drugs, especially Isotretinoin (a medicine prescribed for acne).

There is no treatment that can assure the complete cure of ulcerative colitis. However, there are certain medications and therapies that may improve the symptoms significantly. The ideal treatment of ulcerative colitis aims to treat the inflammation and its associated symptoms. The treatment approach may include either medications or surgery.

Medications to reduce an inflammation: Depending upon your condition and the need, the doctor may prescribe certain medications, such as anti-inflammatory drugs, corticosteroid drugs, immune system suppressors, etc.

Antibiotics: These are usually prescribed if other symptoms of ulcerative colitis are accompanied by fever or any infection.

Medications to control diarrhea: Certain medications such as loperamide may be prescribed to treat severe bloody diarrhea.

Pain killer medications: Acetaminophen is commonly preferred to treat severe pain. Whereas, pain relieving medicines like aspirin or ibuprofen may worsen the pain.

Iron supplements: To treat iron deficiency caused due to intestinal bleeding.

Surgery: When all other approaches fail to cure or relief, surgery is recommended. Usually, the entire colon and/or rectum may be removed.

Alternative medicine

Some alternative therapies may prove beneficial. These may include:

  • Intake of probiotics (beneficial bacteria in the gut)
  • Including fish oil in the diet (reduces inflammation)
  • Drinking aloevera juice (reduces inflammation and have laxative effects)
  • Acupuncture – therapy involving pricking of fine needles into the skin which releases natural pain killer substance from our body
  • Use of turmeric as an adjuvant to other medicines or therapies is believed to improve the symptoms.

Lifestyle interventions:

Adapting the following lifestyle recommendations may help one to cope with the condition:

Diet recommendations:

  • Restrict the intake of dairy products including milk, cheese, curd and so on.
  • Include plenty of food rich in fiber, such as fruits and fresh vegetables.
  • Avoid eating foods such as cabbage, broccoli, fruit juices caffeine, that may aggravate the symptoms.
  • Eat meals in small portions.
  • Eat frequently.
  • Eat plenty of water.
  • Avoid carbonated beverages.
  • To take certain dietary supplements (like minerals, proteins or vitamins) after discussing with your doctor.
  • Remember, this dietary supplement should not be a replacement of your meal, butan additional source of energy.

Some other recommendations may include:

  • Managing stress
  • Regular exercise
  • Breathing exercises
  • Yoga and meditation
  • Therapies like hypnosis (under supervision of trained professionals)

Complications:

Untreated or poorly managed ulcerative colitis may lead to following complications:

  • Blood loss
  • Perforated colon
  • Dehydration
  • Development of kidney stones
  • Osteoporosis (degeneration of bones)
  • Swelling on joints and skin or maybe on the eyes
  • Increases susceptibility to develop colon cancer
  • Problems associated with the liver
*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.