By: Kathy Hubbard
About a month ago, I wrote about Crohn’s disease and told you that some of the symptoms for CD and ulcerative colitis were similar. I promised to circle back to UC, and that’s what we’re going to do today. Please note that some of the symptoms for both of these inflammatory bowel diseases are also present in those with celiac disease, so if you’re inclined to self-diagnose, I’d recommend you see a healthcare professional if any of this hits home.
“Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum,” Mayo Clinic explains. “Symptoms usually develop over time, rather than suddenly. And, most people with ulcerative colitis have mild to moderate symptoms. The course of UC may vary, with some people having long periods of remission.”
The five types of UC are categorized according to their location. Ulcerative proctitis tends to be the mildest. “Inflammation confined to the area closest to the anus (rectum) and rectal bleeding may be the only sign of the disease,” Mayo says.
“Proctosigmoiditis is inflammation that involves the rectum and sigmoid colon (lower end of the colon). Signs and symptoms include bloody diarrhea, abdominal cramps and pain, and an inability to move the bowels despite the urge to do so (tenesmus).”
When the inflammation extends from the rectum up through the sigmoid and descending colon, it’s classified as left-sided colitis. Besides the symptoms for proctosigmoiditis, add pain on the left side and unintended weight loss.
Mayo says that the fourth category, pancolitis, “often affects the entire colon and causes bouts of bloody diarrhea that may be severe, abdominal cramps and pain, fatigue, and significant weight loss.” And finally, acute severe ulcerative colitis is a rare form that causes extreme pain, profuse diarrhea, bleeding, fever, and inability to eat.
If you have any persistent change in your bowel habits, please see your primary care provider. Ulcerative colitis isn’t usually fatal, but it’s a severe disease that, without treatment, can cause life-threatening complications.
The Crohns and Colitis Foundation says that ulcerative colitis is “the result of several factors that are not yet well understood. Abnormal immune response, genetics, microbiome, and environmental factors all contribute to ulcerative colitis.”
Proteins and cells that typically make up our immune systems protect us from infection. So a healthy immune response is for a temporary inflammation to fight off an illness or disease. Then, once we’re back to health, the inflammation goes away, and we’re free of the disease.
“In ulcerative colitis patients, the inflammation persists long after the immune system should have finished its job,” CCF says. “The body continues to send white blood cells into the lining of the intestines, where they produce chronic inflammation and ulcers.”
Diet and stress were once considered contributors to ulcerative colitis. Although stress may increase the chance of a flare-up and some foods can trigger or worsen symptoms, neither is regarded as the source of the illness.
Mayo says that UC is more common in people with a family history of the disease; however, “most people with ulcerative colitis don’t have this family history.” UC can occur at any age, but it’s most common to present in people between the ages of 15 and 30 and older than 60. Males and females are equally susceptible.
“Although whites have the highest risk of the disease, it can occur in any race. If you’re of Ashkenazi Jewish descent, your risk is even higher,” Mayo says.
To diagnose the disease, your provider will most likely order blood tests to check for anemia or signs of infection, in addition to a stool sample. White blood cells in your stool can indicate UC, and the tests can rule out infections caused by bacteria, viruses, and parasites.
Other tests may include a colonoscopy, flexible sigmoidoscopy, X-rays. CT and MRI scans and, of course, he or she will want a full medical history for you and your family. Remember, when I recommended you to get a complete family health history? Now’s the time for it.
Treatment for ulcerative colitis can be as simple as medications or as complicated as surgery. People with ulcerative colitis are at higher risk of colorectal cancer and, as such, will need more frequent screening.
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at firstname.lastname@example.org.