Ulcerative Colitis

Overview

Definition

Ulcerative colitis (UC) is a type of severe, chronic inflammatory bowel disease (IBD), which causes:

  • Inflammation in the lining of the colon and rectum
  • Ulcers in the lining of the colon and rectum
  • Bleeding in the lining of the colon and rectum
Ulcerative Colitis
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Causes

The exact cause is unknown. A virus or bacteria may cause the immune system to overreact and damage the colon and rectum.

Risk Factors

Having a family member with IBD (includes UC and Crohn disease) may increase your risk of developing UC.

SymptomsandDiagnosis

Symptoms

UC may cause:

  • Diarrhea
  • Abdominal cramps and pain
  • Rectal bleeding
  • Anemia
  • Weight loss
  • Fatigue, weakness
  • Nausea
  • Fever
  • Skin rashes
  • Arthritis
  • Eye inflammation, such as uveitis

Intestinal complications of UC may include:

  • Perforation
  • Fistula—abnormal passageway between 2 bodily structures
  • Obstruction
  • Excess bleeding
  • Toxic megacolon—a potentially life-threatening condition when the colon severely expands, which may result in reduced blood flow

Other complications of UC may include:

  • Liver disease
  • Kidney stones
  • Osteoporosis
  • Colon cancer

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Testing may include:

  • Blood tests
  • Stool test
  • Barium enema
  • Flexible sigmoidoscopy
  • Colonoscopy
  • Biopsy

Treatments

Treatment

Treatment options may include:

Dietary Changes

Your doctor may recommend that you avoid certain foods, such as:

  • Dairy (due to lactose intolerance)
  • Alcohol
  • Red and processed meats
  • Refined sugar
  • Saturated fat

Talk to your doctor or dietitian about what foods may work best for you.

Medications

There are a range of medications that may be prescribed, such as:

  • Aminosalicylates
  • Steroid anti-inflammatory medications
  • Immune modifiers
  • Biological agents

Surgery

Surgery involves partial or complete removal of the colon. This may be necessary for:

  • An emergency, such as a perforation, excessive bleeding, or life-threatening infection
  • Long-term disease that does not respond to medications or other treatment
  • Colon cancer—includes confirmed diagnosis or suspicious tissue on examination
  • Lack of growth because of nutritional deficiencies (in children)

Surgery for UC is curative and reduces the risk of colon cancer.

Fecal Transplantation

Fecal transplantation may be used to treat UC.

Prevention

There are no current guidelines to prevent UC.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (UC; Colitis, Ulcerative)

RESOURCES

American Gastroenterological Society http://www.gastro.org 

Crohn's & Colitis Foundation http://www.crohnscolitisfoundation.org 

CANADIAN RESOURCES

Canadian Association of Gastroenterology https://www.cag-acg.org 

Crohn's and Colitis Canada http://crohnsandcolitis.ca 

References

D'Haens GR, Sartor RB, Silverberg MS, Petersson J, Rutgeerts P. Future directions in inflammatory bowel disease management. 2014;8(8):726-734.

Richman S, Schub T. Ulcerative colitis. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/nursing/products/nursing-reference-center. Updated August 2012. Accessed October 3, 2017.

Ulcerative colitis. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T114507/Ulcerative-colitis . Updated July 28, 2017. Accessed October 3, 2017.

Wedlake L, Slack N, Andreyev HJ, Whelan K. Fiber in the treatment and maintenance of inflammatory bowel disease: a systematic review of randomized controlled trials. Inflamm Bowel Dis. 2014;20(3):576-586.

What is ulcerative colitis? Crohn's & Colitis Foundation website. Available at: http://www.crohnscolitisfoundation.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis. Accessed October 3, 2017.

8/31/2015 DynaMed Plus Systematic Literature Surveillance Update  http://www.dynamed.com/topics/dmp~AN~T114507/Ulcerative-colitis : Moayyedi P, Surette MG, Kim PT, et al. Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial. Gastroenterology. 2015;149(1):102-109.