Ulcerative colitis is a chronic inflammatory bowel disease that creates long-lasting inflammation and ulcers in the digestive tract. It can be debilitating and can lead to life-threatening complications. While there is no cure for ulcerative colitis, at Concorde Gastroenterology we have various treatment options that can reduce your symptoms and move the disease toward long-term remission.
What is ulcerative colitis?
Ulcerative colitis is an inflammatory bowel disease that affects the colon and the rectum. It can be confused with Crohn’s disease, which can affect any part of the digestive tract. The inflammation of ulcerative colitis creates ulcers (sores) in the lining of the large intestine, also known as the colon. It can affect the entire colon, but usually affects the sigmoid colon, the lower section.
What are the symptoms of ulcerative colitis?
Symptoms of ulcerative colitis can vary depending on the severity of your inflammation and where in the colon it occurs. The course of ulcerative colitis varies widely, with some patients having lengthy periods of remission. These are some typical symptoms:
- Diarrhea, often with pus and blood
- Rectal pain
- Abdominal pain and cramping
- Rectal bleeding in the stool
- Urgency to defecate
- Inability to defecate despite feeling need
- Weight loss
- Failure to grow (children)
Who gets ulcerative colitis?
About 700,000 people in the U.S. have ulcerative colitis. It typically first starts when the patient is between the ages of 15 and 30. Twenty percent of people with ulcerative colitis have a blood relative with an inflammatory bowel disease.
What causes ulcerative colitis?
The causes of ulcerative colitis remain a mystery, but it is thought to be caused by the person’s immune system overreacting to normal bacteria in the digestive tract. Although these bacteria are normal, the immune system attacks these cells in the digestive tract.
How is ulcerative colitis diagnosed?
At Concorde Gastroenterology, we may use any of these tools to diagnose your ulcerative colitis.
- Blood tests — We will check for anemia, where there aren’t enough red blood cells to carry adequate oxygen to your tissues.
- Colonoscopy — This allows us to see the entire colon, and we can take tissue samples for lab analysis.
- Stool sample — Through stool samples we can rule out other disorders, such as infections caused by bacteria, viruses, and parasites. If your stool has white blood cells, this is an indication of ulcerative colitis.
- Flexible sigmoidoscopy — This thin, flexible, lighted scope is used to examine the rectum and sigmoid (the lower colon).
- X-ray — If your symptoms are severe, an x-ray can rule out complications, such as a perforated colon.
- CT scan — This can reveal how much of the colon is inflamed.
How is ulcerative colitis treated?
These are often our first treatment option for ulcerative colitis:
- 5-aminosalicylates — There are a variety of these drugs. They are taken orally or by enema or suppository, depending on the area of your colon that is affected.
- Corticosteroids — These include prednisone and hydrocortisone and are used in cases of moderate to severe ulcerative colitis. They are not used long term.
Immune system suppressors
Surgery for Ulcerative Colitis
If medications and lifestyle changes don’t make your ulcerative colitis go away or at least create long-term remission, surgery is an option. Surgery usually involves removing your entire colon and rectum.When these are removed, the patient may be able to have a procedure where a pouch is constructed from the end of your small intestine. This is attached to your anus, allowing you to pass waste in a relatively normal fashion. If this is not possible, we may need to create an opening in your abdomen through which stool is passed for collection into an attached bag.