What is ulcerative colitis?
Ulcerative colitis is different from Crohn’s disease, which is also an inflammatory bowel disease. They have similar symptoms, but Crohn's disease can affect any part of your gastrointestinal tract from mouth to anus. Ulcerative colitis only affects your rectum and colon.
Causes of ulcerative colitis
Doctors aren’t sure of the exact cause of ulcerative colitis. But some factors may play a part:
Ulcerative colitis may run in some families. Experts say that if your sibling has ulcerative colitis, you’ll have a higher risk of developing the disease too.
There are microbes such as fungi, bacteria, and viruses, in your digestive tract. These help with digestion, and are known as your microbiome. Researchers say that people who have inflammatory bowel disease may have different microbiomes compared to healthy people.
Immune system reaction
Another possible factor for ulcerative colitis may be an abnormal immune reaction. When your immune system tries to fight off bacteria or viruses, it instead attacks cells in your digestive tract.
Symptoms and signs of ulcerative colitis
Ulcerative colitis symptoms and signs may vary from person to person. Some common signs and symptoms include the following:
Diagnosis of ulcerative colitis
Your doctor will conduct a physical exam and take your medical history. They may also run some tests, including:
- Blood tests
- Stool studies
- Endoscopy. This lets your doctor see your entire colon using a flexible lighted tube.
- Biopsy. Your doctor may take a small sample of your tissue to test it in a lab.
- Chromoendoscopy. During the endoscopy, your doctor may spray a blue liquid dye to highlight changes in your intestinal lining.
Ulcerative colitis treatment
The main goal of treatment is to help you manage your symptoms and immune system. While there's no known ulcerative colitis cure, these treatment options can help you manage your symptoms and let you lead a full life.
Treatment involves either medication or surgery. Your doctor will recommend treatment based on how severe your condition is, and how much of your large intestine is affected.
While medication won't cure the disease, it can help control your symptoms. With medication, you can have long periods without symptoms (remission). During remission, you should continue to take medication and see your doctor regularly.
Medications for ulcerative colitis include:
- Aminosalicylates like balsalazide, olsalazine, sulfasalazine, and mesalamine. These drugs can be given by mouth, through your rectum, or as an enema.
- Corticosteroids. As corticosteroids may have serious side effects, they’re not given long term.
- Immunosuppressants. These drugs decrease your immune system’s activity, but effects may take one to three months to be seen.
- Biologics, which are medicines created from living organisms. These include infliximab, vedolizumab, and ustekinumab.
Your doctor may recommend surgery if you have:
- Colorectal cancer
- Precancerous cells that increase your colorectal cancer risk
- Life-threatening complications, such as a hole in your large intestine or severe rectal bleeding
- Symptoms that don’t stop or improve even after medication
- Symptoms that improve only with corticosteroids. These drugs can cause serious side effects when used long-term.
The standard surgery for ulcerative colitis is the removal of your colon and rectum. The surgery will also change how your body stores and removes stool. There are a few different ways of doing this.
In an ileostomy, your surgeon will attach the end of your small intestine (ileum) to an opening in your abdomen (stoma). A bag will be attached to that opening and worn outside your body (ostomy pouch). This pouch collects your stool.
In an ileoanal reservoir surgery, the surgeon will create a small pouch from your ileum and attach it to your anus. Stool will collect in the pouch and pass out through your anus.
Living with ulcerative colitis
Ulcerative colitis is a lifelong disease with no known cure. But studies show that people with ulcerative colitis tend to have the same life expectancy as people without ulcerative colitis. Most people with this disease are able to lead full lives.
American Family Physician: "Ulcerative Colitis."
Crohn's & Colitis Foundation: "Living with Ulcerative Colitis," "Overview of Ulcerative Colitis," "Types of Ulcerative Colitis," "Ulcerative Colitis Diagnosis and Testing."
Frontiers in Medicine: "Gut Microbiota and Metabolic Specificity in Ulcerative Colitis and Crohn's Disease."
Gastroenterology Research and Practice: "The Immunological Basis of Inflammatory Bowel Disease." Merck Manual: "Ulcerative Colitis."
National Institute of Diabetes and Digestive and Kidney Diseases: "Symptoms & Causes of Ulcerative Colitis," "Treatment for Ulcerative Colitis."
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