What is Ulcer­a­tive Colitis?

Ulcer­a­tive col­i­tis is a dis­or­der that causes chronic inflam­ma­tion of the inner lin­ing of the colon and rec­tum. This inflam­ma­tion causes sores, called ulcers, to form in the lin­ing of the colon. Although many peo­ple expe­ri­ence peri­ods of remis­sion, sur­gi­cal removal of the colon is the only cure for the dis­ease. The goal of ulcer­a­tive col­i­tis treat­ment is to encour­age the patient to go into remis­sion and to main­tain remis­sion. Treat­ment also focuses on relief of ulcer­a­tive col­i­tis pain, relief of other symp­toms, and treat­ment of complications.

Ulcer­a­tive col­i­tis is one of two inflam­ma­tory bowel dis­eases (IBD) or dis­eases that cause inflam­ma­tion of the intesti­nal tract. It dif­fers from the other IBD, Crohn’s dis­ease, in sev­eral ways. First, ulcer­a­tive col­i­tis affects only the intesti­nal lin­ing; Crohn’s dis­ease affects all lay­ers of the intesti­nal wall. Sec­ond, ulcer­a­tive col­i­tis is usu­ally lim­ited to the large intes­tine; Crohn’s dis­ease usu­ally affects the small intes­tine. Finally, ulcer­a­tive col­i­tis tends to be local­ized to one area of the colon and/or rec­tum; inflam­ma­tion in Crohn’s dis­ease can be discontinuous.

Ulcer­a­tive col­i­tis is diag­nosed in both males and females, usu­ally in patients ages 15 to 30. It also rarely occurs in patients ages 50 to 70. Inflam­ma­tory bowel dis­eases appear to run in fam­i­lies, so hav­ing a rel­a­tive with ulcer­a­tive col­i­tis or Crohn’s dis­ease makes a per­son more likely to develop ulcer­a­tive colitis.

Symp­toms of Ulcer­a­tive Colitis

Symp­toms of ulcer­a­tive col­i­tis vary from patient to patient, but may include:

• abdom­i­nal pain and cramps
• feel­ing the need for a bowel move­ment even after fin­ish­ing a bowel movement
• bloody diar­rhea
• rec­tal bleeding
• ane­mia
• nau­sea
• loss of appetite
• weight loss
• fatigue
• fluid loss
• fever
• fail­ure to grow and develop nor­mally, espe­cially in children

The most com­mon symp­toms of ulcer­a­tive col­i­tis are abdom­i­nal pain and bloody diar­rhea. About half of peo­ple with the dis­ease have only mild symp­toms. Oth­ers suf­fer from more severe symp­toms. Ulcer­a­tive col­i­tis can also lead to prob­lems with arthri­tis, osteo­poro­sis, liver dis­ease, and eye inflam­ma­tion, pos­si­bly because the inflam­ma­tion response is trig­gered out­side the colon. Colon can­cer is also more com­mon in patients with ulcer­a­tive col­i­tis. Treat­ment of the under­ly­ing dis­ease helps many of these problems.

Treat­ments for Ulcer­a­tive Colitis

Treat­ment for ulcer­a­tive col­i­tis is focused on encour­ag­ing the dis­ease to go into remis­sion and stay there. Ulcer­a­tive col­i­tis treat­ment also focuses on deal­ing with the symp­toms and pos­si­ble com­pli­ca­tions caused by the dis­ease. Although med­ica­tions can­not cure the dis­ease, sev­eral dif­fer­ent med­ica­tion types are com­monly used to treat ulcer­a­tive col­i­tis and its
symptoms:

• Anti-inflammatory med­ica­tions such as sulfasalazine

• Steroid med­ica­tions such as prednisone

• Immune Sys­tem Sup­pres­sors such as 6-mercaptopurine and aza­thio­prine. These drugs block the body’s immune response.

Other med­ica­tions are used for relief of pain, diar­rhea, or infec­tion caused by the disease.

Surgery is the only cure for ulcer­a­tive col­i­tis, but is per­formed only when other treat­ment options fail. Surgery removes part or all of the colon, depend­ing on the affected area.

Ulcer­a­tive Col­i­tis: Diet and Nutrition

Because ulcer­a­tive col­i­tis can decrease a patient’s appetite as well as inter­fere with the intestines’ abil­ity to absorb nutri­ents, ulcer­a­tive col­i­tis patients need to take spe­cial care to fol­low a nutri­tious diet, drink plenty of water, and avoid foods and drinks that worsen symp­toms. Those with ulcer­a­tive col­i­tis should also avoid alco­hol, which can aggra­vate symptoms.

In severe cases of the dis­ease, doc­tors may pre­scribe vit­a­mins or min­eral sup­ple­ments. How­ever, patients should start new vit­a­mins or sup­ple­ments only with their doctor’s approval.

Ulcer­a­tive Col­i­tis: Addi­tional Information

The fol­low­ing orga­ni­za­tions can pro­vide addi­tional infor­ma­tion on ulcer­a­tive colitis:

• National Diges­tive Dis­eases Infor­ma­tion Clear­ing­house (NDDIC) www.digestive.niddk.nih.gov
• Crohn’s and Col­i­tis Foun­da­tion of Amer­ica, www.ccfa.org