What is ulcerative colitis?
Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes inflammation and sores, called ulcers, in part of the digestive tract. While strictly limited to the large intestines, the location of ulcerative colitis within the colon and rectum can present slightly different symptoms and are classified into three types:
- Ulcerative proctitis – may cause rectal bleeding and pain or urgency with your bowel movements.
- Distal colitis – sometimes inflammation is limited to the left side of the rectum and partially or all the way up to where it bends near the spleen. It’s also known as left-sided colitis and can present pain on that side of your abdomen along with loss of appetite, weight loss and bloody diarrhea.
- Extensive colitis – as the name suggests, inflammation is extensive, covering the whole colon. The symptoms are the same as left-sided colitis, except your abdominal pain is not limited to one side.
What causes ulcerative colitis?
While the exact cause of ulcerative colitis isn’t known, experts believe it’s related to an overactive immune response. In people with ulcerative colitis, the immune system mistakenly attacks healthy tissue in the digestive tract, leading to inflammation and ulcers. Genetics, environmental factors, and changes in gut bacteria may also play a role.
What are symptoms of ulcerative colitis?
Symptoms of ulcerative colitis can vary depending on the severity of inflammation and the area of the colon affected. Common symptoms include:
- Frequent, urgent bowel movements
- Bloody or mucus-filled diarrhea
- Abdominal pain and cramping
- Fatigue
- Weight loss
- Fever
- Rectal pain or bleeding
Symptoms may come and go in cycles, with periods of flare-ups followed by remission.
How is ulcerative colitis diagnosed?
Endoscopic procedures with tissue biopsy are the only way to definitively diagnose ulcerative colitis. A colonoscopy allows your provider to view the entire colon using a thin, flexible, lighted tube with a camera on the end. During the procedure, they will take tissue samples, called a biopsy, to confirm the diagnosis.
What are treatment options for ulcerative colitis?
Treatment of ulcerative colitis focuses on reducing inflammation, relieving symptoms, and maintaining remission. You’re often able to avoid surgery completely by taking medications, such as anti-inflammatory drugs, immune system suppressors, or biologics, and making lifestyle changes.
Adjusting your diet can help you manage your symptoms and prevent flare-ups. There is no single “colitis diet” that works for everyone, and you may need to eat differently when you’re in the middle of flare up than when you’re not. There are several foods that are common colitis triggers and others that many people find more tolerable, especially during flares.
In more severe cases, surgery can eliminate ulcerative colitis and involves removing your entire colon and rectum. This procedure is called a proctocolectomy. In most cases, a proctocolectomy involves another procedure called ileoanal anastomosis (J-pouch) surgery. A J-pouch eliminates the need to wear a bag to collect stool.