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Ulcerative Colitis by Rosalyn Carson-DeWitt, MD

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Definition

Ulcerative colitis (UC) is a severe, chronic inflammatory bowel disease .

It causes:

Inflammation
Ulcers
Bleeding in the lining of the colon and rectum

Ulcerative Colitis

Causes

The cause of ulcerative colitis is not known. Inflammatory bowel diseases (UC and Crohn's disease ) seem to run in some families. Some think that a virus or bacteria causes the immune system to overreact and damage the colon and rectum.

Risk Factors

Having family members with inflammatory bowel disease is the only risk factor.

Symptoms

These factors increase your chance of developing UC. Tell your doctor if you have any of these risk factors:

Diarrhea
Abdominal cramps and pain
Rectal bleeding
Anemia
Weight loss
Fatigue, weakness
Nausea
Fever

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include:

Blood tests
Stool test
Barium enema —injection of fluid into the rectum that makes your colon show up on an x-ray so the doctor can see abnormal spots in your colon
Flexible sigmoidoscopy —a thin, lighted tube inserted into the rectum to examine the rectum and the lower colon
Colonoscopy —a thin, lighted tube inserted through the rectum and into the colon to examine the lining of the colon
Biopsy —removal of a sample of colon tissue for testing (may be performed as part of a flexible sigmoidoscopy or colonoscopy)

Treatment

Avoid Foods That Provoke Symptoms

Dairy foods (due to lactose intolerance )
Highly seasoned foods
High-fiber foods

Talk to your doctor to learn more about what foods to avoid, since this may be different for each person.

Aminosalicylate Medications

Steroid Anti-inflammatory Medications

Immune Modifier Medications

Biological Agents

Infliximab

Surgery

Medication may not cure very severe UC. In some cases, your doctor may suggest surgery . This can involve having all or part of the colon removed. Surgery may also be done because UC increases your risk of colon cancer .

Over time, colitis that is not treated or does not respond to treatment can lead to:

Arthritis
Eye inflammation
Liver disease
Kidney stones
Skin rashes
Osteoporosis
Colon cancer

If you are diagnosed with ulcerative colitis, follow your doctor's instructions .

Prevention

There are no guidelines for preventing ulcerative colitis.

RESOURCES:

American Gastroenterological Society http://www.gastro.org/
Crohn's and Colitis Foundation of America http://www.ccfa.org/

CANADIAN RESOURCES:

The Canadian Association of Gastroenterology http://www.cag-acg.org/default.aspx/
Crohn's and Colitis Foundation of Canada http://www.ccfc.ca/English/index.html/

References:

About ulcerative colitis and proctitis. Crohn's and Colitis Foundation of America website. Available at: http://www.ccfa.org/info/about/ucp . Accessed July 9, 2008.
Goroll AH, Mulley AG, Mulley AG Jr. Primary Care Medicine . 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2000.
Ulcerative colitis. National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/colitis/index.htm . Accessed July 9, 2008.
Ulcerative colitis patient education resources. Digestive Health Initiative. American Gastroenterological Society website. Available at: http://www.gastro.org/wmspage.cfm?parm1=4024 . Accessed July 9, 2008.
Yamada T, Alpers DH. Textbook of Gastroenterology . 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003.

Last reviewed August 2010 by Daus Mahnke, MD

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