What Is Ulcerative Colitis, and How Do I Know If I Have It?

What Is Ulcerative Colitis, and How Do I Know If I Have It?

Ulcerative colitis (UC) is a chronic condition that causes uncomfortable flare-ups and may lead to serious complications if left untreated. With the right care, however, patients can return to their usual routine without persistent symptoms. Bergen Medical Associates provides treatment for many medical conditions, including gastroenterology conditions like UC, at locations near you in northern New Jersey. Here, we discuss ulcerative colitis, its signs, and what treatments are available for patients.

Ulcerative colitis is a type of inflammatory bowel disease (IBD). Inflammatory bowel diseases occur when tissues in the digestive tract become swollen or inflamed. Ulcerative colitis specifically affects the colon, or the large intestine. It causes sores called ulcers along the length of the intestine. There are several types of ulcerative colitis, differentiated by where the ulcers form:

• Ulcerative proctitis: Inflammation and ulcers form in the rectum, or the part of the colon that is closest to the anus.
• Left-sided colitis: Inflammation and ulcers form in the rectum through the descending colon (approximately the lower 1/3 of the colon).
• Pancolitis: Inflammation and ulcers form throughout the entire colon. This type is also called pancolitis.

Like other types of IBD, ulcerative colitis is chronic. This means that the condition lasts through the patient’s lifetime and absent surgical removal of the colon cannot be cured. Fortunately, many treatments exist to manage the symptoms of IBD and reduce its impact. Given the absence of a cure, typically medications are needed for many years. These treatments allow the patient to live normally with milder symptoms, fewer flare-ups, and a higher quality of life.

What Are Symptoms of Ulcerative Colitis?

Most patients experience symptoms of ulcerative colitis in flare-ups when symptoms intensify for a few weeks to a few months at a time. Sometimes, between flare-ups, there are periods of remission when the patient has no symptoms at all. These periods of remission can lead to delays in patients seeking medical attention.  However, some patients do not experience any spontaneous improvement in symptoms and require treatment beginning at the time of diagnosis. Symptoms vary depending on the condition’s severity, but may include:

• Diarrhea
• Increased frequency of bowel movements
• Sudden and urgent bowel movements
• Tenesmus, or feeling the need for a bowel movement without the ability to do so
• Abdominal cramping or tenderness
• Blood, mucus, or pus in stool
• Fatigue, or extreme tiredness
• Sudden and unexplained weight loss
• Nausea
• Fever

Occasionally, the inflammation may spread outside the colon to new parts of the body. Approximately 25% of patients with ulcerative colitis experience a wider set of symptoms, including joint pain, itchy or burning eyes, and painful skin rashes and sores.

What Are Complications of Ulcerative Colitis?

Flare-ups are not only uncomfortable. In some cases, severe symptoms of ulcerative colitis may snowball into serious health complications. These can be life-threatening, requiring urgent treatment in an emergency room. Symptoms include:

• Dehydration
• Perforation, or a hole in the colon
• Severe blood loss
• Blood clots
• Toxic megacolon, where the colon ceases to function.

Ulcerative colitis can also increase a person’s risk of developing other conditions. Inflammation may spread to affect new parts of the body. Repeat flare-ups may also cause scarring in the colon and elsewhere, or they may lead to nutrient deficiencies. Conditions caused by ulcerative colitis include:

• Anemia
• Osteoporosis
• Liver scarring
• Growth issues in children
• Vitamin deficiencies
• Colon cancer

Because complications of UC are potentially serious, medical treatment is recommended. Effective treatment not only treats symptoms of colon inflammation but may also reduce the risk of developing a serious complication.

What Causes Ulcerative Colitis?

The exact cause of ulcerative colitis is not yet known. Researchers believe it occurs due to a complex combination of factors. Some prevailing theories include:

• Immune responses: When trying to combat an invading virus or bacterium, the immune system might mistakenly attack the colon as well, causing inflammation.
• Genetic traits: Ulcerative colitis commonly develops in patients whose family members are also affected, meaning there may be a genetic cause.
• Diet and lifestyle: While unhealthy dietary and lifestyle choices are unlikely to cause ulcerative colitis, they may create an environment in the colon that allows for inappropriate activation of the immune system, thereby triggering flare-ups or causing symptoms to worsen.

While gastroenterologists cannot always determine the cause of ulcerative colitis, the disease has been connected to several known risk factors. These factors do not guarantee that a person has or will have UC, but they do make the disease more likely. Risk factors include:

• Age between 15 and 30 years old
• White or Ashkenazi Jewish descent, although the condition is present in all ethnic groups and the rate of new cases in these groups (including Asian Indians, East Asians, Latinos, Africans) is increasing.
• A family history of ulcerative colitis or Crohn’s disease.

Ulcerative colitis cannot be avoided or prevented. By knowing their risk factors, however, patients can be diagnosed earlier, potentially leading to more effective treatment.

How Is Ulcerative Colitis Treated?

Ulcerative colitis can be treated with either medications or surgery. The recommended approach depends on the condition’s severity and the patient’s overall health:

Drug Therapies

The physician prescribes one or more medications to reduce inflammation in the colon. By soothing irritation, medications help the colon heal more quickly. This reduces the risk of complications. It may also help relieve certain symptoms.

• Aminosalicylates: These drugs reduce inflammation by inhibiting the production of certain molecules in the colon, such as prostaglandins, that increase inflammation. Generally, aminosaliclates are used for mild cases, or in combination with other medications.
• Corticosteroids: These drugs provide powerful relief for inflammation that does not respond to other treatments. Because they cause side effects, they are not used long-term.
• Immunomodulators: These drugs suppress the immune response that starts the inflammation, stopping or sometimes preventing a flare-up.
• Biologics: These drugs work by specifically targeting the proteins and cellular functions that lead to inflammation. They are used for more aggressive forms of UC, often in combination with other medications.
• Other medications: Pain relief medication, antidiarrheals, antispasmodics, and iron supplements can counteract some symptoms of an ulcerative colitis flare-up, but they do not alter the course of the disease.

Surgery

Very severe ulcerative colitis is treated with a surgery called a proctocolectomy. This procedure involves removing the entire colon and rectum. The surgeon then creates a pouch from the end of the small intestine, allowing for normal bowel movements. If a pouch is not possible, then the surgeon will create a permanent opening in the belly, called an ileal stoma. Stool passes through this opening into an attached bag, which must be emptied regularly.

Find Ulcerative Colitis Treatment Near You in New Jersey

Ulcerative colitis is a lifelong condition, but with effective medical care, patients can experience reduced symptoms and long-term remission. Bergen Medical Associates is one of the leading gastroenterology centers in northern New Jersey, providing state-of-the-art treatments for all kinds of gastrointestinal needs and disorders. To learn more about what ulcerative colitis is, request an appointment today. We have locations in Emerson, Montvale, Northvale, Paramus, and Ridgewood, NJ, making it easy to find treatment near you.