What’s Ulcerative Colitis?

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Ulcerative colitis is a difficult disease with causes that are not fully understood by the medical community. The condition may be caused by having previously contracted a virus or bacterial infection, or it could be genetic, as people who have a family with ulcerative colitis are also more likely to develop it. Through various treatments, this disease, which affects the lining of the rectum and colon, creating mild to severe inflammation and sometimes resulting in ulceration of these areas, can be managed but is not curable. Severe cases can prove extremely debilitating and may require not only medical but also therapeutic support to help people cope with the life changes that may ensue.

The main symptoms of ulcerative colitis can vary because the affected area of ​​the colon can be different. There are essentially four recognized types of ulcerative colitis based on where the inflammation occurs and the symptoms that develop. Some people have inflammation and swelling only in the rectum, with no disease affecting the colon. This is called ulcerative proctitis and usually causes problems with bowel movements and bleeding from the rectum.

Ulcerative proctitis can never develop into a disease that affects the entire colon, but this varies. The entire colon can be affected by pancolitis, which can create terrible cramping, excessive sweating, diarrhea which can be bloody, and weight loss. The most severe form of ulcerative colitis is called fulminant colitis, which can lead to colon rupture. The pain with this condition is extreme and diarrhea is frequent. With all forms of ulcerative colitis, cramping and bloody diarrhea are common symptoms.

You should see a doctor if you have these symptoms, especially if they last more than a couple of days and always if you have blood in your stool. Doctors are likely to evaluate you based on a variety of tests, which may include a colonoscopy, a rectal exam, blood tests, X-rays, and a barium enema. Sometimes this form of colitis is confused with Crohn’s disease. The main difference is that the inflammation is usually limited to a single section of the colon and does not affect other areas of the intestine.

Treatment for ulcerative colitis is based on the type, symptoms, and severity. Many people are prescribed anti-inflammatory drugs, but these are not nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. In fact, NSAIDs can make this form of colitis worse and are not recommended. Sometimes drugs such as immunosuppressants may be used, and drugs such as pain relievers, drugs that help stop diarrhea, and drugs to treat anemia can be helpful. The risk of anemia is high as bleeding in the colon can make it difficult to maintain healthy levels of iron.

The symptoms of ulcerative colitis can become so severe that the patient requires surgery. In surgeries, doctors remove all or most of the rectum and colon to prevent further inflammation. Until recently, patients undergoing this surgery therefore had to wear a bag on the outside of the body to collect waste. A new surgery has changed this, allowing people to have bowel movements, even though these occur on a much more frequent basis.

Because the condition can cause so many life changes, support groups or working with a therapist can be of great help. Not everyone affected will end up with extremely severe symptoms, but even minor ulcerative colitis can cause significant pain and many bathroom visits, which can make it difficult to pursue normal activities.

Some patients suffer from severe embarrassment due to excess gas and the frequent need to use the toilet. Having to mention or deal with these symptoms that most people keep very private can keep people from wanting to do much with others and can be very isolating. Support groups like the Crohn’s and Colitis Foundation of America can be great places to start in finding support and information about this condition.

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