Ulcerative colitis: Symptoms, Causes, Risks & Treatments

What is Ulcerative colitis?

Ulcerative colitis is a disease that causes inflammation and sores (ulcers) in the lining of the large intestine (colon camera.gif). It usually affects the lower section (sigmoid colon) and the rectum. But it can affect the entire colon. In general, the more of the colon that’s affected, the worse the symptoms will be.

The disease can affect people of any age. But most people who have it are diagnosed before the age of 30.

Symptoms of Ulcerative colitis

Ulcerative colitis symptoms can vary, depending on the severity of inflammation and where it occurs. Therefore, doctors often classify ulcerative colitis according to its location.

You may have the following signs and symptoms, depending on which part of the colon is inflamed:

• Diarrhea, often with blood or pus
• Abdominal pain and cramping
• Rectal pain
• Rectal bleeding passing small amount of blood with stool
• Urgency to defecate
• Inability to defecate despite urgency
• Weight loss
• Fatigue
• Fever
• In children, failure to grow

Most people with ulcerative colitis have mild to moderate symptoms. The course of ulcerative colitis may vary, with some people having long periods of remission.

Causes of Ulcerative colitis

The exact cause of ulcerative colitis is unknown, although it’s thought to be the result of a problem with the immune system.

Autoimmune condition

The immune system is the body’s defence against infection. Many experts believe ulcerative colitis is an autoimmune condition (when the immune system mistakenly attacks healthy tissue).

The immune system normally fights off infections by releasing white blood cells into the blood to destroy the cause of the infection. This results in inflammation (swelling and redness) of body tissue in the infected area.

In ulcerative colitis, a leading theory is that the immune system mistakes “friendly bacteria” in the colon which aid digestion as a harmful infection, leading to the colon and rectum becoming inflamed.

Alternatively, some researchers believe a viral or bacterial infection triggers the immune system, but for some reason it doesn’t “turn off” once the infection has passed and continues to cause inflammation.

It’s also been suggested that no infection is involved and the immune system may just malfunction by itself, or that there’s an imbalance between good and bad bacteria within the bowel.

Genetics

It also seems inherited genes are a factor in the development of ulcerative colitis. Studies have found that more than one in four people with ulcerative colitis has a family history of the condition.

Levels of ulcerative colitis are also a lot higher in certain ethnic groups, further suggesting that genetics are a factor.

Researchers have identified several genes that seem to make people more likely to develop ulcerative colitis, and it’s believed that many of these genes play a role in the immune system.

Environmental factors

Where and how you live also seems to affect your chances of developing ulcerative colitis, which suggests environmental factors are important.

For example, the condition is more common in urban areas of northern parts of Western Europe and America.

Various environmental factors that may be linked to ulcerative colitis have been studied, including air pollution, medication and certain diets.

Although no factors have so far been identified, countries with improved sanitation seem to have a higher population of people with the condition. This suggests that reduced exposure to bacteria may be an important factor.

Who is at risk for Ulcerative colitis?

Most people with ulcerative colitis don’t have a family history of the condition. However, you’re more likely to develop it if a parent or sibling also has the condition.

Ulcerative colitis can develop in a person of any race, but it’s more common in Caucasians. According to the Mayo Clinic, if you’re an Ashkenazi Jew, you have a greater chance of developing the condition than most other groups.

Some studies show a possible link between the use of the drug isotretinoin (Accutane, Amnesteem, Claravis, or Sotret) and ulcerative colitis. Isotretinoin treats cystic acne.

How is Ulcerative colitis diagnosed?

A health care provider diagnoses ulcerative colitis with the following:

• medical and family history
• physical exam
• lab tests
• endoscopies of the large intestine

The health care provider may perform a series of medical tests to rule out other bowel disorders, such as irritable bowel syndrome, Crohn’s disease, or celiac disease, that may cause symptoms similar to those of ulcerative colitis. Read more about these conditions on the Health A-Z list.

Treatment for Ulcerative colitis

Treatment for ulcerative colitis depends mainly on how bad the disease is. It usually includes medicines and changes in diet. A few people have symptoms that are long-lasting and severe, in some cases requiring more medicines or surgery.

You may need to treat other problems, such as anemia or infection. Treatment in children and teens may include taking nutritional supplements to restore normal growth and sexual development.

If you don’t have any symptoms or if your disease is not active (in remission), you may not need treatment. But your doctor may suggest that you take medicines to keep the disease in remission.

If you do have symptoms, they usually can be managed with medicines to put the disease in remission. It often is easier to keep the disease in remission than to treat a flare-up.

When to see a doctor

See your doctor if you experience a persistent change in your bowel habits or if you have signs and symptoms such as:

• Abdominal pain
• Blood in your stool
• Ongoing diarrhea that doesn’t respond to over-the-counter medications
• Diarrhea that awakens you from sleep
• An unexplained fever lasting more than a day or two

Although ulcerative colitis usually isn’t fatal, it’s a serious disease that, in some cases, may cause life-threatening complications.