Robert Wood Johnson University Hospital
 

Ulcerative Colitis

Ulcerative Colitis

Illustration of the anatomy of the digestive system, adult
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What is ulcerative colitis?

Ulcerative colitis is an inflammatory bowel disease in which the inner lining of the large intestine (colon or bowel) and rectum become inflamed. Inflammation usually begins in the rectum and lower (sigmoid) intestine and spreads upward to the entire colon. Ulcerative colitis rarely affects the small intestine, except for the lower section, the ileum.

The inflammation causes diarrhea, or frequent emptying of the colon. As cells on the surface of the lining of the colon die and slough off, ulcers (open sores) form and may cause the discharge of pus and mucus, in addition to bleeding.

Although children and older people sometimes develop ulcerative colitis, it most often starts between the ages of 15 and 30. It affects males and females equally and appears to run in some families.

Inflammatory bowel diseases

Inflammatory bowel diseases (IBD) include a group of chronic disorders that cause inflammation or ulceration in the small and large intestines. Most often IBD is classified as:

Ulcerative colitis, which causes ulceration and inflammation of the inner lining of the colon and rectum.

Crohn's disease, an inflammation that extends into the deeper layers of the intestinal wall, and also may affect other parts of the digestive tract, including the mouth, esophagus, stomach, and small intestine.

Ulcerative colitis and Crohn's disease cause similar symptoms that often resemble other conditions, such as irritable bowel syndrome (IBS). The correct diagnosis may take some time.

Inflammatory bowel disease may also be referred to as colitis, enteritis, ileitis, and proctitis.

Ulcerative colitis requires long-term medical care. There may be remissions--periods when the symptoms go away--that last for months or even years. However, smptoms eventually return.

Only in rare cases, when complications occur, is the disease fatal. If only the rectum and lower colon are involved, the risk of cancer is not higher than normal. However, the risk of colon cancer is greater than normal in patients with widespread ulcerative colitis.

What are the symptoms of ulcerative colitis?

The following are the most common symptoms of ulcerative colitis. However, each individual may experience symptoms differently. Symptoms may include:

Sometimes, symptoms may also include:

The symptoms of ulcerative colitis may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

What causes ulcerative colitis?

Although many theories exist regarding the cause of ulcerative colitis, none has been proven. The cause of ulcerative colitis is unknown, and currently there is no cure, except through surgical removal of the colon. One theory suggests that some agent, possibly a virus or an atypical bacterium, interacts with the body's immune system to trigger an inflammatory reaction in the intestinal wall.

Although much scientific evidence shows that people with ulcerative colitis have abnormalities of the immune system, doctors do not know whether these abnormalities are a cause or result of the disease.

There is little proof that ulcerative colitis is caused by emotional distress or sensitivity to certain foods or food products.

How is ulcerative colitis diagnosed?

A thorough physical examination, including blood tests to determine whether an anemic condition exists, or if the white blood cell count is elevated (a sign of inflammation), is part of the diagnostic process. In addition, diagnostic procedures for ulcerative colitis may include the following:

Illustration of an esophagogastroduodenoscopy procedure
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What is the treatment for ulcerative colitis?

Specific treatment for ulcerative colitis will be determined by your doctor based on:

While there is no special diet for ulcerative colitis, patients may be able to control mild symptoms simply by avoiding foods that seem to upset their intestines.

When treatment is necessary, it must be tailored for each case, as what may help one patient may not help another. Patients are also given needed emotional and psychological support. Treatment may include:

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