Ulcerative colitis is an inflammatory bowel disease that causes inflammation and sores (ulcers) in the lining of the large intestine. Although it usually affects the S-shaped segment of the colon between the descending section and the rectum, i.e., the sigmoid colon, as well as the rectum itself, the extent of the disease can vary from affecting mainly the rectum to affecting the entire colon. UC is diagnosed in about five of every 10,000 people and can occur in people of any age, but it usually starts between the ages of 15 and 30 and (albeit less frequently) between 50 and 70 years of age. It affects men and women equally and appears to run in families, with reports of up to 20 percent of people with UC having a family member with either UC or Crohn’s disease. A higher incidence of UC is found in Caucasians and people of Jewish descent. Symptoms of UC vary but may include bloody diarrhea, abdominal pain, fever, and unexplained weight loss. Inflammation usually starts in the rectum and may spread to other areas of the colon. It may be difficult for your physician to identify UC and to distinguish it from Crohn’s disease or other types of colitis.The exact cause of UC is unknown. Those afflicted are typically within one of two age groups (15-30 and 50-70). Many theories exist about what causes UC. People with UC have abnormalities of the immune system, but doctors do not know whether these abnormalities are a cause or a result of the disease. UC is not caused by emotional distress or sensitivity to certain foods or food products, but these factors may trigger symptoms in some people.
The most common symptoms of UC are abdominal pain and bloody diarrhea. Patients also may experience one or more of the following:
- Weight loss
- Loss of appetite
- Rectal bleeding
- Loss of body fluids and nutrients
- Skin lesions
- Joint pain
- Growth failure (in children)
About half of the people diagnosed with UC have mild symptoms. Others suffer frequent fevers, bloody diarrhea, nausea, and severe abdominal cramps. UC may also cause problems such as arthritis, inflammation of the eye, liver disease, and osteoporosis. It is unknown why these problems occur outside the colon. Scientists think these complications may be the result of inflammation triggered by the immune system. Some of these problems disappear when the colitis is treated.Proper diagnosis and treatment are critical phases in countering UC. In performing a colonoscopy, your gastroenterologist will remove small tissue specimens (biopsies). These tissue samples are then microscopically examined by a pathologist – a physician who specializes in the diagnosis of disease via microscopic examination of a tissue sample – to determine if an abnormality exists, such as UC. The proper classification of IBD, especially UC versus Crohn’s disease, determines the appropriate treatment options. Should the pathologist establish the diagnosis of UC, he/she will also determine whether other abnormalities are present, e.g., dysplasia (precancer). This information is essential in determining if further treatment is necessary and, if so, what kind will be most appropriate. It is important to accurately evaluate UC because afflicted patients are at increased risk of developing cancer of the colon and/or rectum.
Treatment Options for Ulcerative Colitis:
- Prescription medication therapy – The goals of prescription medication therapy are to alleviate symptoms, prevent attacks of the disease, and promote healing of the colon.
- The drug sulfasalazine may limit the frequency of UC attacks and help eliminate UC symptoms.
- Corticosteroids may also be prescribed to reduce inflammation.
- Many other potentially effective prescription medication options are available; check with your physician.
- Surgery – Surgical removal of the rectum or a segment of the colon may be necessary for patients who fail to respond to prescription medication therapy or if there are complications associated with the disease, such as cancer.
Measures You Can Take to Relieve the Symptoms of Ulcerative Colitis:
- Maintain a high-fiber diet that is low in fat and calories; consult your physician for proper diet and nutrition information.
- Avoid foods that are high in lactose, such as milk and sugar; spicy and acidic foods; foods that worsen diarrhea; and caffeinated beverages, such as cola, coffee, and tea.
- Ensure an adequate daily fluid intake.
Important Questions to Ask Your Doctor:
- How much of my colon is affected by UC?
- What are my treatment options?
- What are the risks and side effects of these treatment options?
- What can I do to take care of myself during and after treatment?
- What will be done to monitor and minimize my cancer risk?
- How long will the treatment last, and what will be my follow-up?
Sources of Additional Information:
American College of Gastroenterology
American Gastroenterological Association
Crohn’s & Colitis Foundation of America
National Institutes of Health
This patient diagnostic fact sheet is provided to you as a service by AmeriPath. It is intended for patient education and information only. It does not constitute advice, nor should it be taken to suggest or replace professional medical care from your physician. Your treatment options may vary, depending upon your medical history and current condition. Only your physician and you can determine your best option.