Ulcerative colitis

Dear Alice,

Ulcerative colitis: What is it?

What are the symptoms?

How would one know if they have it?

Dear Reader,

Ulcerative colitis is an inflammatory disease that affects the colon (the part of your intestinal tract leading up to your anus). It spreads proximally, which means that it spreads backwards in the direction of the large intestine. It’s an inflammatory disease, meaning that the symptoms are a result of your body’s immune system attacking the lining of your colon and not due to a virus or bug. You may have also heard of Crohn’s disease, which is another inflammatory bowel disease. The difference between the two is that ulcerative colitis occurs in the lining of the colon (and is diagnosed more frequently) whereas Crohn’s disease can occur anywhere in the digestive tract.

There are four different types of ulcerative colitis. Proctitis inflammation that is limited to the rectum, proctosigmoiditis is inflammation of the rectum and the sigmoid colon (the lower part of the colon), left-side colitis is when inflammation extends from the rectum up through the sigmoid and descending colon, and finally, pancolitis is when the entire colon is inflamed. If you have ulcerative colitis, your symptoms may include:

  • Bloody stool or diarrhea
  • Abdominal pain
  • Fatigue
  • Weight loss
  • Frequent urge to urinate or defecate
  • Inflammation in the bile duct
  • Rectal pain
  • Fever

To find out whether you have ulcerative colitis, your health care provider may want to rule out another health issue with similar symptoms, including Crohn’s disease, microscopic colitis, or colitis caused by an infectious agent such as bacteria, a virus, or a pathogen. In order to rule out these conditions, your provider may want to perform an endoscopy, such as a colonoscopy or sigmoidoscopy. They may also use blood tests, stool studies and even some imaging procedures such taking an X-ray or computed tomography (CT) scan.

Though what happens to the body when someone has ulcerative colitis has been established, there’s no clear reason why it happens when it does. One possible explanation is that ulcerative colitis could be triggered by an interaction between the body’s immune system and a viral or bacterial infection. When a pathogen is recognized, the body will launch an immune response to get rid of it. The response includes secreting antibodies that will attack an unwanted agent. Swelling and inflammation typically result, which is why it’s called an inflammatory response. A healthy immune response will subside after an infection or illness has cleared up. However, with ulcerative colitis, the immune system fails to shut off properly once the condition has resolved. This atypical immune response causes inflammation in the lining of the colon and leads to the symptoms associated with the condition. Consuming certain products, such as dairy or caffeinated beverages, may also aggravate the symptoms associated with the condition. Furthermore, there is also evidence that the disease is genetically linked, so having a parent or a sibling with the disease puts you at risk for developing it.

There isn’t a cure for this condition, but it isn’t a fatal illness and health care providers can help reduce symptoms. However, persistent inflammation in the colon could increase the risk of colorectal cancer and even osteoporosis, so managing the disease can play a critical role in your body’s overall health. Anti-inflammatory drugs, immunosuppressants, and biologics can be helpful to reduce inflammation in the long-term or short-term respectively. Severe, sudden cases may require surgery to remove part of or the entire colon. For even more information, check out the Crohn’s & Colitis Foundation of America.

Hope this information helps!

Last updated Oct 22, 2021
Originally published Nov 28, 2014

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