Everything you need to know about ulcerative colitis (UC)
Rushing back and forth to the bathroom all day can be stressful and embarrassing and might make activities you once loved, such as taking a road trip or seeing a movie, seem daunting. But ulcerative colitis (UC) is not a life sentence, says David Rubin, M.D., associate professor of medicine and co-director of the Inflammatory Bowel Disease Center at the University of Chicago Medical Center. “It provides people with a challenge—and that challenge can be overcome with the right kind of therapies.”
What is Ulcerative Colitis?
Ulcerative colitis is an inflammatory bowel disease (IBD) of the lining of the colon and rectum. For some reason, in people with UC, the immune system of the gut gets turned on and remains inappropriately active. This causes the immune system’s white blood cells to irritate the colon, triggering chronic inflammation.
The result is the development of ulcers. They usually begin in the outer lining of the rectum and may extend upward into other areas of the colon.
If the inflammation and ulcers are confined to the rectum, the condition is called ulcerative proctitis.
When the colitis travels up the rectum to the sigmoid colon, it is referred to as proctosigmoiditis.
Left-sided colitis occurs in the rectum, sigmoid colon and the splenic fixture. When the entire large intestine is inflamed, it is known as pancolitis.
What are the Symptoms of UC?
Symptoms vary from mild to severe depending on how much of the colon is affected. An urgent need to evacuate the bowel and blood in the stool are the most common manifestations of this inflammatory condition, but some patients also have fecal incontinence and diarrhea, says Feza Remzi, M.D., department chair of colorectal surgery at the Cleveland Clinic in Cleveland. Sufferers may also have gas, constipation, nausea or stomach cramps.
In some cases, those with UC experience anemia, fatigue and weight loss. Most people with UC can expect to experience an ebb and flow of symptoms, occasional flares and even periods of complete relief from problems. In fact, Dr. Rubin says, with proper treatment you should “expect to be in remission, feeling perfect.”
What Causes UC?
When something goes wrong with the bowels, you might think diet or stress is to blame. But ulcerative colitis has not been linked to either (although stress may worsen the disorder when it is active). And although certain risk factors, they still don’t know the cause.
The current understanding is that “there is some genetic susceptibility or predisposition to having the condition, combined with an environmental trigger,” says Dr. Rubin.
Triggers, he explains may include dietary changes, any of a variety of pollutants or even bacteria found in your bowel.
UC is more common in adults ages 15 to 30, but it can affect older people. Men and women develop the disorder at similar rates. A family history of ulcerative colitis, especially in a sibling, also raises your risk, says Dr. Remzi. Certain ethnic groups, such as Ashkenazi Jews, are also at increased risk, as are those who live in developed countries such as the United States.
The good news: Even though ulcerative colitis is a lifelong condition, excellent therapies and effective help are available.
Source: Crohn’s & Colitis Foundation of America, Inflammatory Bowel Disease Center at the University of Chicago Medical Center, Dept. of Colorectal Surgery at the Cleveland Clinic, OH.
UC and Colon Cancer: What's the Connection?
People with long-standing UC have an increased risk of developing colon cancer. Why? The chronic inflammation and ulceration trigger a reaction in the colon’s cells, causing them to become cancerous, explains the Cleveland Clinic’s Dr. Remzi. You are at highest risk if your entire colon is affected, and the longer you have the disease, the greater your risk of cancer. Having regular colonoscopies to catch potential problems early and establishing good control of your colitis will reduce this risk. UC also increases your risk for osteoporosis, a disease in which your bones become brittle and weak—nearly 15 percent of patients develop it. Talk to your doctor about ways to prevent bone loss, and ask to be screened for osteoporosis.