Ulcerative Colitis Fact Sheet

Ulcerative colitis treatment at UK HealthCare

Experts at the multidisciplinary Inflammatory Bowel Disease Clinic can diagnose and treat ulcerative colitis symptoms. The clinic allows patients to see a gastroenterologist and a surgeon in one visit, if needed.

Also called colitis or proctitis, ulcerative colitis is a disease in which the inner lining of the large
intestine (colon or bowel) and rectum becomes inflamed. Ulcerative colitis predominantly affects the large intestine.

The inflammation causes bloody bowel movements and diarrhea, or frequent emptying of the colon. Ulcerative colitis can be difficult to diagnose because its symptoms are similar to other intestinal disorders and another type of inflammatory bowel disease (IBD) called Crohn’s disease. Crohn’s disease differs from ulcerative colitis because it causes inflammation deeper within the intestinal wall. Also, Crohn’s disease usually occurs in the small intestine, although it can also occur in the mouth, esophagus, stomach, duodenum, large intestine, appendix and anus.

Ulcerative colitis requires long-term medical care. Only in rare cases, when complications occur, is the disease fatal. If only the rectum and lower colon are involved, the risk of cancer is not higher than normal. However, the risk of colon cancer is greater than normal in patients with widespread ulcerative colitis.

The most common symptoms of ulcerative colitis are abdominal pain and bloody diarrhea. Patients also may experience the following symptoms:
• Fatigue
• Weight loss
• Loss of appetite
• Rectal bleeding
• Loss of body fluids and nutrients

About half of Ulcerative Colitis patients have mild symptoms. Others suffer frequent fever, bloody diarrhea, nausea, and severe abdominal cramps. Ulcerative colitis also may cause problems such as arthritis, inflammation of the eye, liver disease, osteoporosis, skin rashes and anemia. No one knows for sure why problems occur outside the colon. Scientists think these complications may occur when the immune system triggers inflammation in other parts of the body. Some of these problems go away when the colitis is treated.

Although many theories exist regarding the cause of ulcerative colitis, none has been proven. The cause of ulcerative colitis is unknown, and currently there is no cure other than surgical removal of the colon. One theory suggests that some agent, possibly a virus or a bacteria, interacts with the body’s immune system to trigger an inflammatory reaction in the intestinal wall.

Although much scientific evidence shows that people with ulcerative colitis have abnormalities of the
immune system, physicians do not know whether these abnormalities are a cause or result of the disease.

There is little proof that ulcerative colitis is caused by emotional distress, sensitivity to certain foods or food products, or is the result of an unhappy childhood.

A thorough physical examination, including blood tests to determine whether an anemic condition exists or if the white blood cell count is elevated (a sign of inflammation), is part of diagnosing ulcerative colitis.

In addition, diagnosing ulcerative colitis may include the following:
• Stool culture – checks for the presence of abnormal bacteria in the digestive tract that may cause diarrhea and other problems.

• Colonoscopy or flexible sigmoidoscopy – (also called lower endoscopy) procedures that allows the physician to examine the inside of the large intestine.

• Biopsy – procedure performed to remove tissue or cells from the lining of the colon for examination under a microscope.

• Lower GI (gastrointestinal) series – procedure that examines the rectum, the large intestine and the lower part of the small intestine.

Treatment of ulcerative colitis

While there is no special diet for ulcerative colitis, patients may be able to control mild symptoms by avoiding foods that upset their intestines. Treatment may include the following:
• Medication – Serious cases of ulcerative colitis may require steroids or other anti-inflammatory
medications.
• Hospitalization – Patients with ulcerative colitis occasionally have symptoms severe enough to require hospitalization for intensive immunosuppression to correct malnutrition and to stop diarrhea as well as loss of blood, fluids and mineral salts.
• Surgery – About 25 percent of ulcerative colitis patients eventually require surgery for removal
of the colon because of massive bleeding, chronic debilitating illness, perforation of the colon or risk of cancer.

• Ulcerative colitis and Crohn’s disease are the two most common inflammatory bowel diseases.

• Crohn’s disease and ulcerative colitis affect about 1 million Americans each year.

National Digestive Diseases
Information Clearinghouse (NDDIC)
1-800- 891-5389
www.niddk.nih.gov