Ulcerative Colitis: Symptoms, Treatment & Living With It & Diagnosis

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In the United States, 600,000 to 900,000 people live with ulcerative colitis (UC). Ulcerative colitis is a chronic illness that causes irritation and open sores in the lining of the large intestine. This disease belongs to a group of conditions called irritable bowel disease [NIDDK].

The inflammation usually starts in the rectum, which is close to the anus, and can affect the entire colon. The severity of the disease will depend on the amount of inflammation and its location. Ulcerative colitis can occur in people of all ages, but those most at risk are people between 15 and 30 years old and have a close relative with the condition. [NIDDK]

People with ulcerative colitis tend to get flare-ups, which is when the disease is active, and symptoms are at their worst. During periods of remission, they may not have any symptoms at all. That’s the goal of treating ulcerative colitis: to stay symptom-free for as long as possible.

Symptoms of Ulcerative Colitis

Symptoms of ulcerative colitis tend to vary from person to person, but the most common ones are:

Urgent need to pass a bowel movement
Pain and cramping in the abdomen
Passing pus or mucus with your stool
Having diarrhea
Passing blood with your stool
Having a constant urge to have a bowel movement

Mild symptoms include having fewer than four bowel movements a day and only occasionally passing blood with the stool. The most severe type of ulcerative colitis, fulminant, can cause more than 10 bloody bowel movements daily [NIDDK].

Causes of Ulcerative Colitis

Although the cause of ulcerative colitis is unclear, scientists believe that several factors can impact the development of the condition.

Genes are one factor, with those with family members with the condition or Crohn’s disease being more likely to develop ulcerative colitis themselves.

Abnormal reactions of your immune system also play a role since abnormal autoimmune reactions lead to inflammation [NIDDK].

The microbiome in your digestive tract is made of bacteria, viruses, and fungi that help you digest food. Your microbiome is also a factor in developing ulcerative colitis [NIDDK].

Diagnosis and Treatment of Ulcerative Colitis

To diagnose ulcerative colitis, your doctor will likely run blood tests. If they find low iron levels, it can mean you have bleeding in your rectum or colon.

Your doctor can perform an endoscopy of your large intestine with biopsies to positively diagnose ulcerative colitis [NIDDK]. The endoscopy also helps your doctor see how much of the intestine is affected.

Although there’s no cure for ulcerative colitis, treatment helps reduce symptoms by calming inflammation. The treatment your doctor chooses will depend on the severity of the condition.

Medicine is an excellent option for many people. These include:

Corticosteroids
Aminosalicylates
Immunosuppressants
Biologics

Surgery may be necessary in some cases, especially if medications are not working or you have complications like abnormal growths. Your doctor may remove your whole colon and rectum using an ileoanal reservoir surgery or an ileostomy [NIDDK].

Living With Ulcerative Colitis

Adjusting your diet is one of the most important aspects of living with ulcerative colitis. Your doctor will help you understand what your problem foods are and what might cause a flare-up. These usually include:

Greasy foods
Carbonated beverages
High-fiber foods
High-sugar foods
Alcohol

You will want to drink lots of fluids daily because you’re likely losing a lot of fluids during bouts of diarrhea.

Finding ways of relieving stress is another crucial part of living with UC. Although stress doesn’t cause ulcerative colitis, it can aggravate the frequency and intensity of the symptoms.

Turning to therapy and support groups can help you cope and connect with others who understand the emotional impact of living with an unpredictable and chronic condition.

Because one of the complications of ulcerative colitis is colorectal cancer, ensuring that you get regular testing will allow your healthcare provider to catch the illness as early as possible.

Complications of Ulcerative Colitis

Developing inflammation in other parts of the body besides your intestines is likely with ulcerative colitis. You may experience swelling and joint pain or even have mouth ulcers.

Another concern is osteoporosis, which can occur if you’re not absorbing the necessary nutrients.

A rare but severe complication is called toxic megacolon, where the inflammation allows gas to get trapped, leading to a swollen colon [NIDDK].

Managing Daily Life

Getting a diagnosis of ulcerative colitis is difficult, but turning to the right doctors and finding support makes it possible to live a productive and healthy life. You can find support groups at the Crohn’s & Colitis Foundation and the IBD Support Foundation.