Ulcerative colitis

Ulcerative colitis ranges in severity from mild to debilitating. While there is no known cure, treatment can greatly reduce symptoms and even bring on long-term remission. You'll find effective treatments and a caring gastroenterology team at Atrium Health Floyd and Harbin Clinic.

What is ulcerative colitis?

Ulcerative colitis is one of two types of inflammatory bowel disease (the other type is Crohn's disease). People with ulcerative colitis develop inflammation and sores (ulcers) in the lining of their colon and rectum.

Causes of ulcerative colitis

Doctors don't fully understand what causes ulcerative colitis. Genetics, gut microbiome, immune function and environment likely play a role. One theory suggests that ulcerative colitis occurs when a bacterial or viral infection triggers an abnormal immune response in the intestine.

Ulcerative colitis symptoms

Ulcerative colitis symptoms depend on which part of the colon is affected and the extent of the damage. Common symptoms include:

• Abdominal pain and cramping
• Diarrhea, often with blood or pus
• Passing a small amount of blood with stool (rectal bleeding)
• Urgent bowel movements
• Urge to have a bowel movement, even if your bowels are empty (tenesmus)

Ulcerative colitis can also cause other symptoms, such as:

• Fatigue
• Fever
• Slow growth in children (failure to thrive)
• Weight loss

Most people with ulcerative colitis have mild or moderate symptoms. Some go for long periods without symptoms (remission). Less often, the disease is more serious. Fulminant ulcerative colitis is a rare form that causes severe symptoms and requires urgent treatment.

Complications that can occur in ulcerative colitis include:

• Extreme dehydration
• Perforations (holes) in the intestine caused by ulcers
• Severe rectal bleeding
• Toxic megacolon, in which the colon stops working

Ulcerative colitis diagnosis

Doctors diagnose ulcerative colitis based on:

• Medical and family history
• Physical exam
• Blood and stool tests
• Colonoscopy to collect a small tissue sample for microscopic analysis (biopsy)

Ulcerative colitis risk factors

One risk factor for ulcerative colitis is family history. Your risk is four times higher if you have a first-degree relative with the disease. Age is also a risk factor. Diagnosis peaks between ages 15 and 30, although you can develop ulcerative colitis at any age.

Ulcerative colitis prevention

There are no known ways to prevent ulcerative colitis.

Ulcerative colitis treatment

Medications to reduce inflammation and bring about remission are usually the first treatment for ulcerative colitis. Your doctor may also recommend dietary changes to:

• Eliminate foods that make symptoms worse
• Optimize nutrition to lessen the effects of ulcerative colitis on your overall health

Despite these treatments, about one in five people continue to have symptoms or develop severe complications. In these cases, doctors usually recommend surgery to remove the colon and rectum. You may have an opening in your abdomen after surgery to collect stool (ileostomy). A newer surgical procedure connects your small intestine to your anus to allow you to pass stool normally.

Living with ulcerative colitis can be stressful. Talk to your doctor about support groups and other resources that can help you cope.