Ulcerative Colitis – Symptoms and Causes
Understanding Ulcerative Colitis
Ulcerative colitis affects nearly one million Americans, making it the most common form of inflammatory bowel disease. This chronic condition causes inflammation and ulcers in the inner lining of the large intestine (colon) and rectum.
While there is no cure, proper treatment can help manage symptoms and even lead to periods of remission. Ulcerative colitis can affect people of all ages but is most commonly diagnosed before age 30.
The condition varies in severity from mild to severe and can significantly impact quality of life. Most people experience periods of active illness followed by times when symptoms disappear.
The exact cause remains unknown, but researchers believe it involves an abnormal immune response, genetic factors, and environmental triggers.
White individuals, especially those of Ashkenazi Jewish descent, have higher risk rates. Having a first-degree relative with the condition also increases your risk.
Signs and Symptoms
Ulcerative colitis can cause various symptoms depending on where inflammation occurs in the digestive tract and how severe it is. Each person may experience different symptoms.
Common symptoms include:
- Bloody diarrhea (stool may contain blood or pus)
- Stomach pain and cramping
- Pain in the rectal area
- Urgent need to have a bowel movement
- Feeling unable to completely empty bowels despite urgency
- Unexplained weight loss
- Feeling very tired
- Fever
- Poor growth in children
About half of people with this condition have mild to moderate symptoms. Many experience periods where symptoms go away for some time before returning.
Different Types of Ulcerative Colitis
Healthcare providers typically group ulcerative colitis based on which part of the colon is affected:
Ulcerative Proctitis
In this type, inflammation only affects the rectum (the area closest to the anus). Some people may only experience rectal bleeding and difficulty with bowel movements.
Left-sided Colitis
This type involves inflammation from the rectum up through the left portion of the colon. A subtype called proctosigmoiditis affects both the rectum and sigmoid colon (the S-shaped section of the lower colon). People with this type often have:
- Bloody diarrhea
- Stomach cramps and pain
- Feeling like they need to have a bowel movement but cannot (tenesmus)
Widespread Colitis
Sometimes called pancolitis, this type affects most or all of the colon. It typically causes:
- Severe episodes of bloody diarrhea
- Intense stomach pain and cramping
- Extreme tiredness
- Significant weight loss
When to Contact a Doctor
You should see a healthcare professional if you notice:
- Ongoing changes in your bowel habits
- Blood in your stool
- Stomach pain that doesn’t go away
- Diarrhea that doesn’t improve with over-the-counter medicines
- Diarrhea that wakes you up at night
- Unexplained fever lasting more than a couple of days
While ulcerative colitis isn’t usually life-threatening, it is a serious condition that can sometimes lead to dangerous complications if not properly treated.
Causes
The root cause of ulcerative colitis remains unknown. While many people once believed that diet and stress triggered this condition, medical experts now understand these factors may only worsen symptoms rather than cause the disease itself.
Research points to two primary factors that might contribute to ulcerative colitis:
Immune system dysfunction: The body’s defense system may mistakenly attack digestive tract cells when fighting off viruses or bacteria, causing inflammation and damage.
Genetic factors: People with family members who have ulcerative colitis face a higher risk of developing the condition. Scientists have identified several genetic markers associated with this disease.
These factors likely work together in complex ways that researchers are still working to understand fully.
Risk Factors
Several factors may increase your chance of developing ulcerative colitis:
Age
This condition usually develops before age 30, but it can occur at any age, including after 60.
Genetic Background
People with White ancestry face a higher risk of ulcerative colitis. Those with Ashkenazi Jewish heritage have an even greater likelihood of developing this condition.
Family Connections
Having a close blood relative, such as a parent, sibling, or child, with ulcerative colitis increases your risk of developing the disease.
Ulcerative colitis affects men and women at roughly equal rates, with no gender showing a higher tendency toward the condition.
Potential Complications
Ulcerative colitis can lead to several serious health issues if not properly managed. These include severe bleeding from the intestinal lining, and perforation (a hole in the colon wall).
Dehydration from ongoing diarrhea and anemia due to blood loss can also occur. Osteoporosis (bone thinning) is another potential complication. Inflammation can also affect the skin, joints, and eyes.
Other possible complications include toxic megacolon (severe colon swelling), an increased risk of blood clots, and a higher risk of colon cancer. Children with ulcerative colitis may experience delayed growth and development.
Diagnosis
Doctors use a combination of methods to diagnose ulcerative colitis:
| Diagnostic Method | Purpose |
|---|---|
| Medical history review | Identify symptoms and risk factors |
| Blood tests | Check for anemia and infection markers |
| Stool studies | Look for white blood cells and rule out pathogens |
| Colonoscopy | View the colon and collect tissue samples |
| Flexible sigmoidoscopy | Examine the rectum and lower colon |
| Imaging tests | X-rays, CT scans, or MRIs to assess inflammation |
Treatment Options
Treatment aims to reduce inflammation, manage symptoms, and achieve remission. Options include:
- Anti-inflammatory medications: Reduce inflammation in the digestive tract.
- Immune system suppressants: Control the immune response that triggers inflammation.
- Biologic therapies: Target specific proteins in the immune system.
- Symptom management: Antidiarrheals, pain relievers, and supplements.
- Surgery: Removal of damaged tissue or the entire colon in severe cases.
Living with ulcerative colitis often requires lifestyle adjustments. Maintaining a food diary is an effective way to uncover individual triggers related to your eating habits.
Many find benefits in eating smaller meals, staying hydrated, and limiting dairy, caffeine, alcohol, and carbonated drinks. Consulting with a registered dietitian can help maintain proper nutrition when a diet becomes restricted.
The emotional impact of ulcerative colitis shouldn’t be overlooked. Managing stress through exercise, relaxation techniques, and seeking support from therapists familiar with inflammatory bowel disease can help. Support groups connect patients with others facing similar challenges.
