Do I have Ulcerative Colitis?

Ulcerative Colitis (UC) affects up to 120,000 people in the UK.

It is an inflammatory bowel disease (IBD) that causes long-lasting inflammation in part of the digestive tract. Like Crohn’s disease, UC can be debilitating and sometimes can lead to life-threatening complications. It is a chronic condition: symptoms usually develop over time, rather than appearing suddenly.

UC usually affects only the innermost lining of the large intestine (colon) and rectum. Unlike Crohn’s, which can occur anywhere in the digestive tract and often spreads deeply into affected tissue, UC occurs only through continuous stretches of the colon.

The cause of ulcerative colitis is unknown. People with this condition have problems with the immune system. But, it is not clear if immune problems cause this illness. Stress and certain foods can trigger symptoms. But they do not cause ulcerative colitis

There’s no known cure for Ulcerative Colitis. But therapies are available that may dramatically reduce symptoms and even bring about long-term remission.

Signs & Symptoms of Ulcerative Colitis
  • Abdominal pain
  • Blood and/or mucus in stool
  • Diarrhoea that does not respond to over-the-counter (OTC) medications
  • Unexplained fever lasting more than 1-2 days
drawing of intestine showing ulcerative colitis

Risk Factors

Age

UC usually begins before 30 years. But, it can occur at any age, and some people develop the disease in their 50s and 60s.

Race or ethnicity

White people have a higher risk of the disease than other ethnicities. People of Ashkenazi Jewish descent have the highest risk.


Family history

Isotretinoin use
Isotretinoin is a medication sometimes used to treat scarring cystic acne or acne that doesn’t respond to other treatments. It was sold under the brand name Accutane, but that brand has been discontinued. Now sold under the brand names Amnesteem, Claravis, and Sotret. There is conflicting information on whether isotretinoin use can increase the risk of IBD. Some studies have suggested a possible link, while other studies have found no such evidence.

UC Classification

Ulcerative colitis symptoms can vary, depending on the severity of inflammation and where it occurs. For these reasons, UC is often classified according to its location.

Proctosigmoiditis

This form involves the rectum and the lower end of the colon, known as the sigmoid colon. Bloody diarrhoea, abdominal cramps and pain, and an inability to move the bowels in spite of the urge to do so (tenesmus) are common problems associated with this form of the disease.

Left-sided colitis

Inflammation extends from the rectum up through the sigmoid and descending colon These are located in the upper left part of the abdomen. Signs and symptoms include bloody diarrhoea, abdominal cramping and pain on the left side, and unintended weight loss.

Ulcerative proctitis

Inflammation is confined to the area closest to the anus (rectum), and rectal bleeding may be the only sign of the disease. Other people may have rectal pain and a feeling of urgency. This form of UC tends to be the mildest.

Fulminant colitis

This rare, life-threatening form of colitis affects the entire colon and causes severe pain. Profuse diarrhoea and, sometimes, dehydration and shock are also symptoms. People with fulminant colitis are at risk of serious complications, including colon rupture and toxic megacolon. This a condition that causes the colon to rapidly expand.

Pancolitis

Affecting more than the left colon and often the entire colon, pancolitis causes bouts of bloody diarrhoea that may be severe, abdominal cramps and pain, fatigue, and significant weight loss.

Tests

UC mimics other bowel diseases such as Crohn’s disease. So a doctor will run several tests to rule out other conditions. Stool tests are used to examine for blood, bacteria, and parasites.
Also blood tests, a complete colonoscopy of the rectum, colon and terminal ileum (the end of the small intestine that intersects with the large intestine), as well as X-rays. This evaluation helps determine the extent and severity of UC, rules out other diseases such as Crohn’s disease or cancer.

5 drawings of ulcerative colitis
image of medicines and ulcerative colitis on paper

Treatment

Treatment depends on how severe the condition is and how often symptoms occur.

The main aims of treatment are to:
  • reduce symptoms
  • maintain remission
This usually involves taking various types of medicine, although surgery may sometimes be an option. Medication could be one of the following:
  • Aminosalicylates
  • Corticosteroids
  • Immunosuppressants