What is ulcerative colitis?
Ulcerative colitis is an inflammatory bowel disease (IBD) in which the inner lining of the large intestine (colon or bowel) and rectum become inflamed. Inflammation usually begins in the rectum and lower (sigmoid) intestine and spreads upward to the entire colon. Ulcerative colitis rarely affects the small intestine, except for the lower section, the ileum.
The inflammation causes diarrhea, or frequent emptying of the colon. As cells on the surface of the lining of the colon die and slough off, ulcers (open sores) form and may cause the discharge of pus and mucus, in addition to bleeding.
Although children and older people sometimes develop ulcerative colitis, it most often starts between the ages of 15 and 30. It affects males and females equally and appears to run in some families.
Ulcerative colitis requires long-term medical care. There may be remissions -- periods when the symptoms go away -- that last for months or even years. However, symptoms eventually return.
Only in rare cases, when complications occur, is the disease fatal. If only the rectum and lower colon are involved, the risk of cancer is not higher than normal. However, the risk of colon cancer is greater than normal in patients with widespread ulcerative colitis.
What are the symptoms of ulcerative colitis?
The following are the most common symptoms of ulcerative colitis. However, each individual may experience symptoms differently. Symptoms may include:
Loss of appetite
Loss of body fluids and nutrients
Anemia caused by severe bleeding
Sometimes, symptoms may also include:
The symptoms of ulcerative colitis may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
What causes ulcerative colitis?
Although many theories exist regarding the cause of ulcerative colitis, none has been proven. The cause of ulcerative colitis is unknown, and currently there is no cure, except through surgical removal of the colon. One theory suggests that some agent, possibly a virus or an atypical bacterium, interacts with the body's immune system to trigger an inflammatory reaction in the intestinal wall.
Although much scientific evidence shows that people with ulcerative colitis have abnormalities of the immune system, physicians do not know whether these abnormalities are a cause or result of the disease.
There is little proof that ulcerative colitis is caused by emotional distress or sensitivity to certain foods or food products.
How is ulcerative colitis diagnosed?
A thorough physical examination, including blood tests to determine whether an anemic condition exists, or if the white blood cell count is elevated (a sign of inflammation), is part of the diagnostic process. In addition, diagnostic procedures for ulcerative colitis may include the following:
Stool culture. Checks for the presence of abnormal bacteria in the digestive tract that may cause diarrhea and other problems. A small sample of stool is collected and sent to a laboratory by your physician's office. In two or three days, the test will show whether abnormal bacteria, bleeding, or infection are present.
Esophagogastroduodenoscopy (also called EGD or upper endoscopy). A procedure that allows the physician to examine the inside of the esophagus, stomach, and duodenum (the first part of the small intestine where the absorption of vitamins, minerals, and other nutrients begins). A thin, flexible, lighted tube called an endoscope is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the physician to view the inside of this area of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy (if necessary).
Colonoscopy. Colonoscopy is a procedure that allows the physician to view the entire length of the large intestine, and can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the physician to see the lining of the colon, remove tissue for further examination, and possibly treat some problems that are discovered.