Ulcerative Colitis

What are the symptoms of ulcerative colitis?

These symptoms can develop over time and call for a visit to your clinician:

• Diarrhea, often with blood or pus
• Abdominal pain and cramping
• Rectal pain
• Rectal bleeding – passing small amount of blood with stool
• Urgency to defecate or inability to defecate despite urgency
• Weight loss or loss of appetite
• Ongoing diarrhea that doesn’t respond to over-the-counter medications
• Fatigue
• Fever that’s unexplained and lasts for a day or two
• Failure to grow (in children)

Failure to treat ulcerative colitis can lead to serious complications such as severe bleeding, dehydration, bone loss, an increased risk of colon cancer and an increased risk of blood clots.

What causes ulcerative colitis?

While diet and stress may aggravate ulcerative colitis, they are not causes. One suspect is an abnormal response by your immune system that leads to an attack on the cells of your own digestive tract. Ulcerative colitis is also more common in people who have family members with the disease. However, most people with ulcerative colitis don’t have this family history.

How is ulcerative colitis diagnosed?

Your clinician will first want to rule out other causes for your symptoms. To help confirm a diagnosis of ulcerative colitis, you may have one or more of the following procedures:

• Blood tests
• Stool sample
• Flexible sigmoidoscopy
• X-ray
• Enterography (a test that uses computed tomography imagery or MRI technology to view the small intestine)

How is ulcerative colitis treated?

Treatment usually involves either drug therapy or surgery.

Medication

Several categories of drugs may be effective in treating ulcerative colitis. These might include anti-inflammatory drugs, immune system suppressors, anti-diarrheal medications, pain relievers and iron supplements. The type you take will depend on the severity of your condition. Because some drugs have serious side effects, your clinician will weigh the benefits and risks of any treatment.

Surgery

Surgery can often eliminate ulcerative colitis. But that usually means removing your entire colon and rectum (proctocolectomy). In most cases, an ileal pouch anal anastomosis is conducted, allowing you to expel waste in a relatively normal manner. When a pouch is not possible, surgeons make a permanent opening in your abdomen through which stool passes for collection in an attached bag.

Cancer surveillance

You will need more-frequent screening for colon cancer because of your increased risk. Your clinician will determine how often you need a colonoscopy based on the location of your disease and how long you have had it.

Can lifestyle changes improve ulcerative colitis?

While ulcerative colitis can be challenging, changes in your diet and lifestyle may help control your symptoms and lengthen the time between flare-ups. Here are some foods to limit or avoid:

• Dairy products. These can cause diarrhea, abdominal pain and gas.
• Fiber. If you have IBD, high-fiber foods such as fruits, vegetables and whole grains may make your symptoms worse. If raw fruits and vegetables bother you, try steaming, baking or stewing them.
• The cabbage family. This includes broccoli and cauliflower as well as nuts, seeds, corn and popcorn.
• Spicy foods, alcohol and caffeine. These may make your signs and symptoms worse.

Other recommendations

• Eat five or six small meals a day rather than two or three larger ones.
• Drink plenty of water. Alcohol and beverages that contain caffeine can make diarrhea worse, while carbonated drinks produce gas.
• Talk to a dietitian if you begin to lose weight or your diet has become very limited.
• Stress can make your symptoms worse and may trigger flare-ups, so calm is best.
• It can be helpful to keep a food diary to keep track of what you’re eating, as well as how you feel.
• If you discover that some foods are causing your symptoms to flare, you can try eliminating them.