Understanding Ulcerative Colitis
Ulcerative colitis (UC) is an inflammatory condition of the large intestine (colon and rectum). The inflammation
is usually limited to the rectum and lower colon, but it may also involve the entire
Ulcerative colitis differs from another inflammatory bowel disease (IBD), Crohn’s
disease. Crohn’s can affect any part of the gastrointestinal (GI) tract from mouth to anus. Ulcerative
colitis, on the other hand, affects only the colon and rectum.
Doctors perform tests to determine the location/type of ulcerative colitis. Symptoms
may vary depending on the extent of inflammation in the rectum and the colon.
Ulcerative colitis is often limited to the rectum and lower colon but can involve
the entire colon.
Prevalence of Ulcerative Colitis
About 700,000 people in the United States have ulcerative colitis, with males and
females affected equally. On average, people are diagnosed with UC
in their mid-30s, although the disease can occur at any age.
Who Gets Ulcerative Colitis?
Though the cause of ulcerative colitis is not fully understood, researchers believe
it to be a result of a combination of factors involving genetics, the environment,
and the immune system. Here are some of the things that are known:
Genetic Factors: About 20% of patients have a close relative with ulcerative colitis.
However, based on current research, there is no way to predict which, if any, family members will develop ulcerative colitis.
The prevalence of ulcerative colitis is higher among white people of European origin and among people of Jewish heritage.
One theory is that certain environmental factors may trigger the immune system to cause inflammation that continues without control. Some of these factors include geography, social issues, microorganisms, and intestinal bacteria.
Immune System Factors: Researchers believe substances in the intestine are mistaken for foreign or invading substances (antigens). These antigens may be the direct cause of the inflammation, or they may stimulate the body's defenses to produce an inflammatory reaction. Normally, your immune system causes temporary inflammation to combat these antigens, and then the inflammation will be reduced as you regain health. In people with ulcerative colitis, however, this inflammation can persist long after your immune system should have finished its job.
Some people believe that ulcerative colitis may be caused by the foods we eat. However, no studies have suggested that diet can either cause or treat ulcerative colitis and there is no specific diet that patients with the disease should follow, although it is advisable to eat a balanced diet. Likewise, there is no convincing evidence that ulcerative colitis results from food allergies.
Symptoms of Ulcerative Colitis
Common ulcerative colitis symptoms are often dependent on the location, the extent, and the severity of the inflammation, and may include:
- Persistent diarrhea: Some people with ulcerative colitis have diarrhea many times a day and need to wake up at night to go to the bathroom. Blood in the stool can also occur with diarrhea
- Looser, more urgent bowel movements
- Rectal bleeding/bloody stool
- Crampy abdominal pain: Pain is often cramping and intermittent; the abdomen may be sore when touched. Abdominal pain may feel like a dull, constant ache depending on the location of inflammation
- Tenesmus: A constant feeling of needing to pass stools
- Loss of appetite
- Weight loss
If you're still experiencing symptoms, talk to your gastroenterologist about your treatment options.
Use the Find a Gastro locator tool if you don't already have one.
Ulcerative Colitis Diagnosis
To diagnose ulcerative colitis, doctors evaluate the patient's history, symptoms, physical exams, and a variety of laboratory
tests. These tests could include:
- Blood tests
- Stool test
- Flexible sigmoidoscopy
- Computerized tomography (CT) scan
- Barium enema X-ray
Ulcerative colitis can be difficult to diagnose, because symptoms can be similar to other intestinal disorders. Patients
with suspected ulcerative colitis can be referred to gastroenterologists who specialize
in ulcerative colitis and other IBDs.