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Ulcerative Colitis – Everything You Should Know

Ulcerative colitis is a chronic disorder that negatively affects your digestive system. It is an abnormal inflammation in the inner space of your colon and rectum, which makes up a significant part of your large intestine. The inflammation usually leads to the development of open sores (ulcers) in the large intestine. Although Ulcerative Colitis usually appears between ages 15 and 30, it can develop at any age. The most significant challenge that people with Ulcerative Colitis face is the flare-ups. The inflammation flares up multiple times throughout life, causing recurring signs and symptoms.

Ulcerative colitis is not a rare condition as many people worldwide suffer from the condition. Data suggest that in the United States, the disease accounts for a quarter-million provider visits annually. The most common symptoms that Ulcerative Colitis patients experience are frequent diarrhoea (often with blood), abdominal pain and cramps and pus or mucus in the stool. Other signs and symptoms include fever, nausea, fatigue and loss of appetite. In addition, chronic bleeding from the inflamed and ulcerated intestinal tissue can cause a drop in haemoglobin in patients.

How does it affect you?

The condition also leads to several health issues. For example, people with this disorder often experience unhealthy weight loss as they have difficulty absorbing enough nutrients and fluids from their diet. In addition, affected children usually grow more slowly than usual. Although it is not so common, Ulcerative Colitis causes skin, eyes, joints, kidneys, or liver issues. However, these complications occur most likely due to abnormal inflammation. Furthermore, Ulcerative Colitis also increases the risk of colon cancer, especially in people having the disease for years.

Ulcerative colitis is one of the two major types of inflammatory bowel disease (IBD). Crohn’s disease is another type of IBD that causes chronic inflammation of the intestines. However, unlike ulcerative colitis, which affects only the inner surface of the large intestine, Crohn’s disease may cause inflammation in any part of the digestive system. In addition, the inflammation extends deeper into the intestinal tissue.

Ulcerative Colitis: Simplified Overview

Ulcerative colitis is an Inflammatory Bowel Disease (IBD) comprising a group of diseases affecting the gastrointestinal (GI) tract. It usually occurs when inflammation affects your rectum, colon (large intestinal lining) or both. Although the exact causes of the disease are unknown, experts suggest that the primary cause of the disease is abnormal immune reactions that cause inflammation in the digestive tract. The inner lining, i.e. the large intestine, is most vulnerable to this disease and is susceptible to ulcers. These ulcers cause various complications, making Ulcerative Colitis a troublesome condition.

Multiple organs in our digestive system work together to digest the food. Ulcerative colitis affects two major digestive parts- the rectum and colon. The disease primarily affects the inner linings of these organs, leading to mild or severe inflammation. People with mild UC can lead a healthy life with some modifications and little effort. In contrast, Ulcerative Colitis leading to chronic inflammation can further lead to many diseases like colon cancer. 

Symptoms of Ulcerative Colitis

Symptoms of Ulcerative Colitis vary depending on the severity level and the area of inflammation, and some symptoms are common. Here are the common symptoms of UC.

Bloody Diarrhoea

It is the most common symptom that people with this condition have. Experts believe that it is one of the hallmark symptoms of Ulcerative Colitis (UC). It results from active mucosal inflammation, ulceration, and inflammatory polyps. In addition, it can cause extreme dehydration, which can be dangerous to your health.

Abdominal Pain and Cramps

Since UC negatively affects some parts of your colon and rectum, it can lead to abdominal cramps and pain. It arises due to ulcers caused in the inner walls of the rectum and colon. However, you might not notice these symptoms if the effect of Ulcerative Colitis is mild. Also, not all abdominal pain and cramp are signs of UC. Constipation, overeating and muscle pain can also lead to these issues.

Urgency to Defecate

Another symptom is a sudden need to rush to the bathroom and the urge to empty your bowels frequently. The condition is known as faecal urgency. Sometimes it results in the inability to defecate despite the urgency. Many people already suffering from diarrhoea may also experience these symptoms. In addition, a study says that people suffering from constipation also face these issues.

Sudden Weight Loss (Unhealthy)

Whenever you suffer from such digestive diseases, your hydration levels drop. If ulcerative colitis is left untreated, then it may become severe. At the severe stage of this disease, one may notice weight loss. However, sometimes you lose weight due to other factors too. For example, nausea and belly pain may kill your interest in eating something, resulting in a weight drop.

Other Symptoms

AnaemiaNauseaBlood, mucous, or pus in bowel movementsSevere crampingFeverSkin rashesMouth soresJoint painRed and painful eyesLiver diseaseLoss of fluids and nutrients

Types of Ulcerative Colitis

Medical science determines the various types of Ulcerative Colitis as per the area that suffers inflammation. Here are the five primary types of UC.

Ulcerative Proctitis 

It is the mildest form of Ulcerative Colitis. It primarily affects only the rectum, the section of your colon closest to your anus. There are fine ulcerations in the inner mucosal lining of the large intestine. These ulcers do not penetrate inside the bowel muscle wall. In most cases, rectal bleeding is the only symptom of the condition. 

Research says that the course of the disease is variable, ranging from complete resolution to easily maintained remission to frequent relapses or refractory disease. For example, some patients experience rapid remission with little or no further illness, while others have frequent exacerbations and require additional medical management. In addition, some people will have a difficult-to-control disease. Similarly, the extent of the disease is also variable. For example, some patients remain confined to the rectum, while others demonstrate proximal colonic involvement.

Although it is an acute form of UC, it doesn’t vanish naturally. It requires medical care and a proper healthy routine. Patients should take the condition seriously because it can become severe if not treated.

Proctosigmoiditis

It attacks the rectum and sigmoid colon. The sigmoid colon is the S-shaped last part of the intestine that connects with the rectum. The most common symptoms include: 

The urgency to go to empty the bowel, Rectal bleeding, Moderate pain on the lower left side of the abdomenCramps and bloody diarrhoeaThe feeling that you need to pass stools despite the bowel is empty. The condition is also known as Tenesmus.

The current treatment for proctosigmoiditis involves medicines and surgery. However, surgery does not completely help to get rid of the disease, and it can occasionally occur in some other colonic areas. Some people also make dietary and lifestyle modifications to relieve and regulate the symptoms. 

Left-Sided Colitis

As its name suggests, left-sided colitis affects the left side of the colon. It produces symptoms similar to the other types of ulcerative colitis, such as diarrhoea and abdominal pain. However, it only affects the distal colon, the last portion of the colon. It damages rectal walls, and you constantly feel a need for bowel movement. 

Pancolitis

It is the inflammation of the entire colon. Besides Ulcerative Colitis causes, some infections and conditions like Rheumatoid Arthritis can also cause Pancolitis. Rheumatoid arthritis is an inflammation disorder. The common symptoms of Pancolitis are:

Common mild and moderate symptoms of pancolitis include:

Fatigue and ExhaustionUnhealthy Weight LossPain and Cramps in the AbdomenA strong and frequent urge for bowel movements, but failing to control the bowel movements

As your pancolitis gets worse, you’ll likely have more severe symptoms. These may include:

Rectum and Anal pain and bleedingFrequent feverBloody diarrhoeaDiarrhoea filled with pus

Causes of Ulcerative Colitis

The current studies say that the exact causes of Ulcerative Colitis are unknown. However, doctors and healthcare experts believe that some factors are likely to cause Ulcerative Colitis. For example, research demonstrates UC as an autoimmune condition, where the body’s defence against infection goes wrong. As a result, it attacks healthy tissues. But, again, the exact causes of the immune system behaving that way are unclear. Most experts think it’s a combination of genetic and environmental factors. Here are some common factors that can lead to the condition.

Genetics

If your parents suffer from UC, you probably might also get symptoms of this disease. However, it is not always true that one has a family history of getting infected with UC. 

As stated above, UC can be an autoimmune disorder. That means it can result from the immune system mistakenly attacking the healthy body tissues rather than protecting them. Immune disorders also lead to other chronic conditions like diabetes.

Environmental Factors

Studies show that the microbiomes of patients with IBD and those who don’t have it differ. Healthcare professionals and researchers believe that it is due to environmental factors. For example, an unclean household environment may give birth to bacteria and viruses. These bacterias may enter your body and cause Ulcerative Colitis.

Ulcerative Colitis: Diagnosis

Research guidelines on the diagnosis of Ulcerative Colitis say that health practitioners must rule out other illnesses before diagnosing ulcerative colitis in adolescents, teenagers, and adults. Other bowel disorders, such as Crohn’s disease, are similar to UC. 

The diagnosis process involves an assessment of your medical and family history, doing a physical examination, and lab tests. According to studies, lab tests are essential in UC to determine the severity of Ulcerative Colitis. In addition, tests also help understand the extent of colonic inflammation. These tests also help rule out other health problems that may cause symptoms similar to ulcerative colitis, such as infections, irritable bowel syndrome, or Crohn’s disease.

Here are some of the standard tests to diagnose Ulcerative Colitis.

Blood tests reveal indicators of infection or anaemia, a condition in which your blood has too little iron. In addition, these tests could indicate that you’re experiencing colon or rectum bleeding.Your doctor can examine the lower part of your colon with flexible sigmoidoscopy. It involves the insertion of a bendable tube into your lower intestine through your bottom. On the end of the tube are a tiny light and a camera. Stool samples can reveal signs of infection, parasites (tiny creatures that can dwell within a person’s body), and inflammation.X-rays are less common tools to diagnose the disease. However, your doctor may request one in exceptional circumstances.CT Scan involves using radio waves that pass through your abdomen and pelvis. It works as an X-ray and helps the doctor examine the inflammation or injury in the intestine.

Ulcerative Colitis: Treatment

There’s no cure for ulcerative colitis. However, treatments can calm the inflammation. In addition, they help you feel better and get you back to your daily activities. Treatment also depends on the individual’s disease severity. Usually, medical science helps manage the disease with medications. It will help maintain remission and improve the quality of life for patients.

Medication

The medication the doctor recommends ultimately depends upon the type of Ulcerative Colitis you are suffering and the severity. For mild effects, doctors may prescribe pills to reduce the inflammation in the rectum and colon. The medical drugs commonly used to treat mild Ulcerative Colitis are the following:

MesalamineSulfasalazineBalsalazideDipentum

These medications have adverse effects on some people, so doctors also use antibiotics to treat such diseases. If a person has moderate to severe Ulcerative Colitis symptoms, doctors may prescribe biologics. Some of them are:

InfliximabTofacitinibUstekinumabVedolizumab

Surgery

In some untreatable conditions, Ulcerative Colitis leads to colon blockage and excessive bleeding. A CT scan helps detect such problems. In that case, the doctor recommends surgery. It involves the removal of the colon and rectum to provide a new pathway to get waste out of your body. The surgeons do it by making a small opening through your abdominal wall.

In some other types of surgery, doctors try to remove only the diseased part of the colon and retain the outer muscles of the rectum. After such surgeries, bowel movements will be frequent and more liquified.

Natural Remedies

Adding some herbs to your diet may aid recovery from Ulcerative Colitis and help relieve symptoms. The natural herbs that help in reducing symptoms of this disease are:

Boswellia

It comes from the Boswellia Serrata tree. The herb works well on the condition, stops the inflammation caused in your body, and tries to reverse the disease.

Psyllium

It is a fibre-rich supplement. It helps regulate bowel movements and remove toxins from the body. However, the condition worsens after taking such supplements in some exceptional cases. Hence, consult your doctor before using it.

Turmeric

Turmeric is known to be a natural antiseptic and helps to fight many diseases. This herb comes with thousands of benefits and has minimal side effects. It is an antioxidant and can help relieve the inflammatory symptoms of Ulcerative Colitis.

Dietary Modifications

Since some of the medicines prescribed for UC cause side effects in some individuals, people try to regulate the condition’s symptoms through dietary modifications. However, they do not cure the disease but can help control its symptoms and make you feel better. The most crucial factor while making dietary modifications is eliminating foods that may lead to or worsen inflammation in your body. You can read more about the kind of foods to eat and avoid in Ulcerative Colitis here.

When to See a Doctor?

If you face symptoms that indicate Ulcerative colitis, it is good to have a doctor’s advice first. However, some of the symptoms do not mean vulnerability to Ulcerative Colitis. Nevertheless, below mentioned symptoms show a high possibility that you are infected with Ulcerative Colitis and need a doctor’s advice.

Severe abdominal cramps and pain in the abdomen area: Get quick help if you face extreme pain in the lower part of the stomach or if there is pain in the abdomen muscles.Bloody diarrhoea and urge to use the bathroom repeatedly: It is a severe condition that is usually not treatable. Hence, seek emergency help when you get your first bloody diarrhoea.High fever: Malfunctioned immune activity can lead to Ulcerative Colitis. When your immune system becomes overactive, your body temperature rises, resulting in a high fever.Swelling and pain in joints like knee and shoulders: If you find difficulty walking or sitting properly and feeling pain in your joints and ligaments, consult your doctor. It may indicate Ulcerative Colitis.

Conclusion

Ulcerative colitis is an inflammatory bowel disease that affects your gastrointestinal tract. Experts believe that it is an autoimmune disorder. However, the exact causes of the disease are unknown. In addition, there is no permanent cure for the disease. However, the doctors may offer surgical removal of your colon and rectum in severe cases, and this would be permanent, though an extreme solution in severe cases. So, surgery is the only way to get rid of it permanently. Hence, it is essential to watch your symptoms and never ignore them. Besides medications, healthy dietary patterns also help relieve the symptoms. The best practice is to maintain a food journal to assess what foods cause inflammation flare-ups. Then, you can modify your food plans accordingly and consider other triggering agents and prevent further flare-ups. However, it is best to make any changes in your food plans after consulting a doctor. 

Frequently Asked Questions (FAQs)

Q. How long does colitis usually last?

A. Ulcerative colitis is usually a lifelong disease. If you suffer from the mild effect, a few inflammatory medicines may help kill that discomfort. However, the repetition risk of this disease is possibly lifelong. If you suffer from moderate to severe effects, it will be lifelong. But, you can regulate the symptoms and discomfort by carefully monitoring your condition and taking proper medication.

Q. What does Ulcerative Colitis pain feel like?

A. A person who has Ulcerative Colitis may feel abdominal cramps. It feels like something badly contracting inside their belly. In addition, abdominal muscles also feel sore and lead to pain. Ulcerative colitis symptoms are mainly related to the abdomen as this disease affects the inner lining of the large intestine and rectum.

Q. Is Greek yoghurt good for colitis?

A. Greek yoghurt is a good source of calcium, protein and probiotics. So, it can be helpful in colitis because it can restore good bacteria in the gut. Apart from Greek yoghurt, plain curd is also beneficial in Ulcerative Colitis. 

Q. Can you drink coffee with Ulcerative Colitis?

A. Products containing caffeine may worsen the situation of Colitis patients. Therefore, it is advised not to take caffeine-containing products like tea, chocolates etc., if you have Ulcerative Colitis. In addition, you should never drink soda.

Q. What vitamins should I take with Ulcerative Colitis?

A. Vitamins such as Vitamin D and Vitamin B12 help relieve Ulcerative Colitis. Some minerals may also help, like iron, zinc and calcium. The use of probiotics may also improve the condition. However, you should always consult a doctor before taking vitamin supplements or minerals.

Q. What food can heal Ulcerative Colitis?

A.Dietary modification in Ulcerative Colitis also depends on the severity of the condition. In some cases, doctors temporarily ask patients to eat low-fibre food to find some relief from the chronic pain and the urge to empty the bowel frequently. However, you can eat high fibre foods like beans and nuts for long-term relief. In addition, foods rich in protein, including meat, fish and eggs, are beneficial. Furthermore, whole fruits and vegetables act as a source of vitamins and antioxidants, which may help in Ulcerative Colitis.

Q. What happens if ulcerative colitis is left untreated?

A. If a person who has ulcerative colitis does not seek medical help, it may worsen the condition. At a later stage, it may lead to colon cancer. In addition, in rare cases, it can lead to toxicity, which can be dangerous to your health. 

A. Stools and their types depend significantly on the type and severity of colitis. For example, you may notice bloody stools in patients with severe Ulcerative Colitis. It relies on the degree of inflammation in the rectum and colon.

Q. Can colitis cause a gurgling stomach?

A. It is one of the symptoms of Ulcerative Colitis. Abdomen pain and cramps are common, causing a gurgling or splashing sound in the intestine. Bloody stools and possibly pus stools are possible symptoms. 

Q. Does colitis cause leg pain?

A. Pain and swelling in joints are some common symptoms of colitis. Usually, knee pain and shoulder pain occurs in Colitis patients. However, some studies suggest that Arthritis symptoms may occur in 25% of patients.

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