Ulcerative Colitis Explained: From Symptoms to Treatment Options

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) of the large intestine (colon). It causes inflammation and ulcers in the colon’s lining, resulting in a variety of painful symptoms. People with ulcerative colitis have flare-ups (active symptoms) and remissions.

Symptoms of Ulcerative Colitis

Symptoms of ulcerative colitis can vary in severity and may come and go. Common symptoms include:

• Bloody diarrhea
• Abdominal pain and cramping
• Urgent bowel movements
• Rectal pain
• Weight loss 
• Fatigue 
• Fever 
• Anemia
• Joint pain or swelling 
• Skin problems 
• Mouth sores 

Causes and Risk Factors of Ulcerative Colitis

The specific cause of ulcerative colitis is unknown, but it is thought to be a mix of hereditary and environmental factors. The immune system is thought to have a role, as an aberrant immune response targets the colon lining.

The risk factors for ulcerative colitis are:

• Age: Most people get UC between the ages of 15 and 30, however it can happen at any age.
• Family history: Having a close family with UC raises your risk.
• Ethnicity:  People of Ashkenazi Jewish origin face a higher risk.

Diagnosis of Ulcerative Colitis

Diagnosing ulcerative colitis typically involves a combination of tests:

• Blood tests: These can help detect anaemia and inflammation.
• Stool tests: To rule out infections and check for blood in the stool.
• Colonoscopy: A procedure where a flexible tube with a camera is inserted into the colon to visualize the lining and take biopsies (tissue samples) for analysis.
• Flexible sigmoidoscopy: Similar to colonoscopy, but examines only the lower part of the colon.
• CIBD Profile: Chronic Inflammatory Bowel Disease profile blood test is a series of tests used to help diagnose and differentiate between Crohn’s disease and ulcerative colitis, two types of IBD.
• Fecal Calprotectin: Fecal calprotectin is a protein found in stool that can be measured to assess for inflammation in the gastrointestinal tract. 

Treatment Options for Ulcerative Colitis

The goal of ulcerative colitis treatment is to reduce inflammation, alleviate symptoms, and achieve and sustain remission. Treatment alternatives include:

• Aminosalicylates (5-ASA): These drugs minimize colon inflammation and are frequently used as the first-line treatment for mild to moderate UC. They can be administered orally or rectally (via suppositories or enemas).
• Corticosteroids: These are used to treat inflammation in the short term, particularly during flare-ups. However, they are not suggested for long-term use due to the possibility of negative effects.

• Immunomodulators: These are drugs that suppress the immune system and help to keep patients in remission. They can take several months to be effective.
• Biologic therapies: Biologic treatments are drugs that lower inflammation by targeting specific immune system proteins. They are primarily utilized in cases of mild to severe UC.

Complications of Ulcerative Colitis

Ulcerative colitis can lead to several complications, including :

• Bleeding: Which can lead to anemia 
• Toxic megacolon: A life-threatening condition where the colon becomes severely distended.
• Perforation of the colon: A hole in the colon, which can lead to infection 
• Increased risk of colon cancer: People with UC have an increased risk of developing colon cancer, especially if the disease is extensive and long-standing.
• Liver disease 
• Osteoporosis 
• Dehydration 

Living with ulcerative colitis

Living with ulcerative colitis can be difficult, but with the right treatment, many individuals can live full and active lives. Important factors in managing UC are:

• Follow your doctor’s treatment regimen.

• Making dietary modifications to avoid trigger foods.
• Managing Stress
• Getting frequent exercise.
• Seeking support from a therapist or support groups.
• Avoid milk & milk products

If you suspect you have ulcerative colitis, consult a doctor for a diagnosis and treatment. With the right care, you can control your symptoms and enhance your quality of life.