Ulcerative colitis is a form of inflammatory bowel disease. It is a chronic (long-term) illness that is associated with inflammation and ulcerations in the lining of the colon and rectum.

• The ulcerations can be associated with bleeding, mucus, and pus.
• All or part of the colon and rectum may be affected.

Healthcare providers do not know the exact cause of ulcerative colitis. However, they think it may be caused by a combination of environmental, genetic and immune factors.

• Ulcerative colitis often begins between ages 15 and 30.
• It occurs more often in Caucasians and people with a Jewish heritage.

The primary symptoms of ulcerative colitis are abdominal pain and bloody diarrhea that often contains pus and mucus.

• The symptoms may vary a lot from time to time, especially when treatment is being given.
• The condition is usually associated with periods of worsening and remission.

Symptoms of mild ulcerative colitis include:

• Four or fewer episodes of diarrhea a day
• Intermittent rectal bleeding
• Urgency when needing to have a bowel movement
• Abdominal cramping, often in the lower left quadrant
• Cramping that is relieved by having a bowel movement

Symptoms of moderate ulcerative colitis include:

• Five to six episodes of bloody diarrhea a day
• Abdominal pain and tenderness
• Mild fever

Symptoms of severe ulcerative colitis include

• More than six episodes of bloody diarrhea a day
• Severe abdominal pain and tenderness
• Fever

Contact your healthcare provider if you have symptoms of ulcerative colitis. He or she will look at your medical history and perform a physical exam. To check the severity of your disease and response to treatment, they may order:

• Imaging studies (X-ray, CT or MRI)
• Lab work
• Stool sample

Some procedures that may be ordered include a flexible sigmoidoscopy and colonoscopy.

• A flexible sigmoidoscopy is a procedure that allows a healthcare provider to see inside the rectum and lower part of the colon (also known as the sigmoid colon).
• A colonoscopy is a procedure that allows a healthcare provider see inside the entire colon.
• A healthcare provider will generally not recommend a colonoscopy if you have severe symptoms. This is due to the risk of putting a hole in the bowel (perforation).

The goal of treatment for ulcerative colitis is to improve symptoms and prevent future episodes.

• The recommended treatment depends on the severity of the disease and treatment you have already received.
• Treatment also depends on whether you have had any complications from the condition.

Treatment for ulcerative colitis includes:

• Eating a healthy diet that is low in saturated and trans fats, sodium and sugar
• Eating smaller meals throughout the day
• Limiting your intake of caffeine and gas-producing foods
• Medications to control the inflammation and/or suppress the immune system
• Antibiotics, antidiarrheals and/or analgesics
• Nutritional supplements to help correct vitamin and mineral deficiencies.

If you are unable to take in enough nourishment or your bowels need a rest, you may need intravenous feedings.

You made need surgery if your symptoms are severe, medication has not provided relief or you have complications of ulcerative colitis.

• There are two primary surgical procedures for ulcerative colitis. Both surgeries include removal of the colon and rectum.
• Your healthcare provider will only do surgery when your symptoms do not respond to medication.

Make an appointment with your healthcare provider if you have symptoms of colitis.

• Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
• Make a list of your medications (including over-the-counter).
• Write down any questions, symptoms or concerns you want to talk about.

Here are some questions to ask your healthcare provider.

• What is my diagnosis and what treatment are you recommending? Are there any alternatives?
• When might I start to see improvement in my symptoms?
• What are the side effects of the medication you are recommending?
• Is there an over-the-counter medication alternative available for the prescription medication I'm taking?
• Will the medication I'm taking for ulcerative colitis interfere with any other medications I'm taking?
• What should I do if I miss a dose of my medication?
• What tests do I need? What is the reason for those tests? Will the test results change my treatment plan?
• What should I do if my symptoms worsen?
• What are my follow-up plans and what symptoms should I report before my next appointment?

Make sure you understand your treatment plan, any possible alternatives, and what medications are recommended (including possible side effects). If surgery is recommended, you should understand why that recommendation was made. Seek a second opinion if necessary.

Source UHC.com

Also known as:

Ulcerative Colitis - Colonoscopy

Hernia

Colonoscopy

Colitis