Ulcerative Colitis

What is ulcerative colitis?

Ulcerative colitis is part of a
group of diseases called inflammatory bowel disease (IBD).

It is when the lining of your large
intestine (the colon or large bowel) and your rectum become red and swollen (inflamed).
In most cases the inflammation begins in your rectum and lower intestine and moves up to
the whole colon.

Ulcerative colitis does not
normally affect the small intestine. But it can affect the lower section of your small
intestine called the ileum.

The inflammation causes diarrhea,
making your colon empty itself often. As the cells on the lining of the colon die and
come off, open sores (ulcers) form. These ulcers may cause pus, mucus, and bleeding.

In most cases, ulcerative colitis
starts between the ages of 15 and 30. Sometimes children and older people get it. It
affects both men and women and seems to run in some families (hereditary).

Ulcerative colitis is a long-term
(chronic) disease. There may be times when your symptoms go away and you are in
remission for months or even years. But the symptoms will come back.

If only your rectum is affected,
your risk of colon cancer is not higher than normal. Your risk is higher than normal if
the disease affects part of your colon, and greatest if it affects your whole colon.

In rare cases, when severe problems
happen, ulcerative colitis can lead to death.

What causes ulcerative colitis?

Experts don’t know what causes
ulcerative colitis.

It may be that a virus or bacteria
affect the body’s infection-fighting system (immune system). The immune system may
create abnormal redness and swelling (inflammation) in the intestinal wall that does not
go away.

Many people with ulcerative colitis
have abnormal immune systems. But experts don’t know if immune problems cause the
disease. They also don’t know if ulcerative colitis may cause immune problems.

Having stress or being sensitive to
some foods does not seem to cause ulcerative colitis.

Right now there is no cure except
for surgery to remove the colon.

Who is at risk for ulcerative colitis?

Some things may make you at higher
risk for ulcerative colitis. These include your:

  • Age. The disease most often starts when you are between the ages of 15
    and 30 years old.
  • Family
    history. 
    Having a family member or close blood relative with
    ulcerative colitis raises your risk of the disease.
  • Race and
    ethnicity. 
    It happens more often in white people and people of Jewish
    descent.

What are the symptoms of ulcerative colitis?

Each person’s symptoms may vary.
The most common symptoms include:

  • Belly pain
  • Bloody diarrhea
  • Extreme tiredness (fatigue)
  • Weight loss
  • Loss of appetite
  • Rectal bleeding
  • Loss of body fluids and nutrients
  • Loss of blood (anemia) caused by
    severe bleeding

In some cases, symptoms may also
include:

  • Skin sores
  • Joint pain
  • Redness and swelling (inflammation) of
    the eyes
  • Liver disorders
  • Weak and brittle bones
    (osteoporosis)
  • Rashes
  • Kidney stones

The symptoms of ulcerative colitis
may look like other health problems. Always see your healthcare provider to be sure.

How is ulcerative colitis diagnosed?

Your healthcare provider will give
you a physical exam. You will have some blood tests. The blood tests will check the
amounts of your red blood cells and white blood cells. If your red blood cell count is
low, this is a sign of anemia. If your white blood cell count is high, this is a sign of
redness and swelling (inflammation).

Other tests for ulcerative colitis
include:

  • Stool
    sample test.
    This test checks for any abnormal bacteria in your digestive tract that may
    cause diarrhea and other problems. To do this, a small stool sample is taken and sent
    to a lab. In 2 or 3 days, the test will show if there is any abnormal bacteria,
    bleeding, or an infection.
  • Upper
    endoscopy.
    This is also called esophagogastroduodenoscopy (EGD). This test looks at the
    inside or lining of your food pipe (esophagus), stomach, and the top part of your
    small intestine (duodenum). This test uses a thin, lighted tube, called an endoscope.
    The tube has a camera at 1 end. The tube is put into your mouth and throat. Then it
    goes into your esophagus, stomach, and duodenum. Your healthcare provider can see the
    inside of these organs. He or she can also take a small tissue sample (biopsy) if
    needed.
  • Colonoscopy.This test looks at the full length of your large intestine. It can help check
    for any abnormal growths, tissue that is red or swollen, sores (ulcers), or bleeding.
    A long, flexible, lighted tube called a colonoscope is put into your rectum up into
    the colon. This tube lets your healthcare provider see your colon lining and take out
    a tissue sample (biopsy) to test it. He or she may also be able to treat some
    problems that may be found.
  • Biopsy.Your healthcare provider will take out a tissue sample or cells from the lining
    of your colon. This will be checked under a microscope.
  • Lower GI
    (gastrointestinal) series.
    This is also called a barium enema. This is an X-ray exam of your rectum, the
    large intestine, and the lower part of your small intestine (the ileum). You will be
    given a metallic fluid called barium. Barium coats the organs so they can be seen on
    an X-ray. The barium is put into a tube and inserted into your rectum as an enema. An
    X-ray of your belly will show if you have any narrowed areas (strictures), blockages,
    or other problems.
  • Blood
    tests.
    No blood test can diagnose or rule out ulcerative colitis. But
    some blood tests can help to monitor the disease.