Ulcerative colitis is a condtion in which the lining of the large intestine (colon) and rectum become inflamed. It is a form of inflammatory bowel disease (IBD). Crohn disease is a related condition.
Inflammatory bowel disease - ulcerative colitis; IBD - ulcerative colitis
The cause of ulcerative colitis is unknown. People with this condition have problems with the immune system. However, it is not clear if immune problems cause this illness. Stress and certain foods can trigger symptoms, but they do not cause ulcerative colitis.
Ulcerative colitis may affect any age group. There are peaks at ages 15 to 30 and then again at ages 50 to 70.
The disease can begin the rectal area. It may involve the entire large intestine over time. It may also start in the rectum and other parts of the large intestine at the same time.
Risk factors include a family history of ulcerative colitis or other autoimmune diseases, or Jewish ancestry.
The symptoms can be more or less severe. They may start slowly or suddenly. Half of people only have mild symptoms. Others have more severe attacks that occur more often. Many factors can lead to attacks.
Symptoms may include:
Children's growth may slow.
Other symptoms that may occur with ulcerative colitis include the following:
Exams and Tests
Colonoscopy with biopsy is most often used to diagnose ulcerative colitis. Colonoscopy is also used to screen people with ulcerative colitis for colon cancer.
Other tests that may be done to help diagnose this condition include:
The goals of treatment are to:
You may need to be treated in the hospital for severe attacks. Your doctor may prescribe corticosteroids. You may be given nutrients through a vein (IV line).
DIET AND NUTRITION
Certain types of foods may worsen diarrhea and gas symptoms. This problem may be more severe during times of active disease. Diet suggestions include:
You may feel worried, embarrassed, or even sad or depressed about having a bowel accident. Other stressful events in your life, such as moving, or losing a job or a loved one can cause digestive problems.
Ask your health care provider for tips on your to manage your stress.
Medicines that may be used to decrease the number of attacks include:
Surgery to remove the colon will cure ulcerative colitis and removes the threat of colon cancer. You may need surgery if you have:
Most of the time, the entire colon, including the rectum, is removed. After surgery, you may have:
Social support can often help with the stress of dealing with illness, and support group members may also have useful tips for finding the best treatment and coping with the condition.
The Crohn's and Colitis Foundation of America (CCFA) has information and links to support groups.
Symptoms are mild in about half of people with ulcerative colitis. More severe symptoms are less likely to respond well to medicines.
Cure is only possible through complete removal of the large intestine.
The risk of colon cancer increases in each decade after ulcerative colitis is diagnosed.
You have a higher risk for small bowel and colon cancer if you have ulcerative colitis. At some point, your provider will recommend tests to screen for colon cancer.
More severe episodes that recur may cause the walls of the intestines to become thickened, leading to:
Problems absorbing nutrients may lead to:
Less common problems that may occur include:
When to Contact a Medical Professional
Call your health care provider if:
There is no known prevention for this condition.
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Mowat C, Cole A, Windsor A, Ahmad T, Arnott I, Driscoll R, et al. Guidelines for the management of inflammatory bowel disease in adults. Gut. 2011 May;60(5):571-607.PMID: 21464096 www.ncbi.nlm.nih.gov/pubmed/21464096.
Sands BE, Siegel CA. Crohn's disease. In: Feldman M, Friedman LS, Brandt, LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 111.
Review Date: 11/20/2014
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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