Do you experience severe bowel urgency? Perhaps you also have recurring bloody stool and feel pain in your abdomen and rectum. If you have been experiencing these symptoms and they are affecting your activities of daily living, it might be time to consult your doctor because these are signs of ulcerative colitis. 

A condition that affects  the large intestine, ulcerative colitis is a chronic condition that causes your colon to swell. This lifelong condition is an inflammatory bowel disease (IBD) that can lead to ulcers and open sores. It’s also a recurring condition which you may rarely feel the symptoms or experience them frequently at once. 

Causes of ulcerative colitis

Whether you are male or female, young or old, healthy or unhealthy, this disease can impact your life. The causes of ulcerative colitis are unknown – while lifestyle, particularly stress management and diet, can worsen this condition, they cannot trigger ulcerative colitis. 

While the exact cause of ulcerative colitis is unknown, studies have linked environmental and genetic factors to this condition’s development. Certain types of genes can affect the maturation and function of T cells, making you prone to an overactive immune response. 

Whatever the cause, it’s still important to understand what can affect your condition. That way, you can better handle and adapt to the diagnosis, especially since this is a chronic condition. 

Risk factors for ulcerative colitis

There are some factors that can increase your likelihood of developing ulcerative colitis:

  • A family history of ulcerative colitis
  • A history of infection 
  • Exposure to substances that might trigger gastrointestinal inflammation
  • Excessive consumption of food rich in polyunsaturated fatty acid
  • A sedentary lifestyle

Types of ulcerative colitis

The type of ulcerative colitis you have depends on the location of the ulcers. Symptoms may vary from person to person. Some common types include:

  • Ulcerative proctitis

The inflammation is only located less than six inches of the rectum. You may show signs of rectal bleeding, rectal pain, and bowel urgency if you have this type of ulcerative colitis.

  • Left-sided colitis

The left side of your bowel is swelling⁠, specifically from the rectum to the bend between the transverse and descending colon, Symptoms include cramping on the left side of the abdomen, weight loss, bloody diarrhea, and loss of appetite.  

  • Proctosigmoiditis

Proctosigmoiditis only affects your rectum and the lower end of your colon, called the sigmoid colon. When you have this type of ulcerative colitis, you will most likely feel an urge to move your bowels, but little or no stool will come out. Additionally, you might also experience signs similar to left-sided colitis. 

  • Extensive colitis

Extensive colitis, or pancolitis covers the entire colon, from the rectum to beyond the splenic flexure (bend near the spleen). If you experience loss of appetite, diarrhea, bloody stool, abdominal pain, and weight loss, you might have extensive colitis.

Additional signs of include fever, anemia, and an inability to defecate despite urgency.  

How is ulcerative colitis diagnosed?

Learning about the different IBD tests can prepare you for the procedures to come. You can expect your physician to recommend some of these tests:

  • Lab test

Your doctor will order a stool analysis for signs of infection such as bacteria and parasites. They can also look at the white blood cells or other proteins found in your stool to confirm if you have ulcerative colitis.  

You may also have to undergo blood tests to detect anemia. It can also determine if your bowels are inflammed through the levels of your white blood cells, protein albumin, and C-reactive protein. 

  • Endoscopies

An endoscopy is a procedure in which a long flexible tube with a camera attached is inserted into the body for examination . There are two kinds of endoscopies to determine whether you have ulcerative colitis. One is a sigmoidoscopy, where the physician will look at your rectum and lower colon; the other is a colonoscopy, which examines the inflammation of your entire colon and large intestine.

During an endoscopy, your physician may perform a biopsy where they remove a small piece of tissue from inside your intestine to be sent to the lab for disease screening. 

  • Imaging 

You might need an X-ray or CT scan.  Your doctor may want to check your colon for abnormal findings such as dilation, obstruction or perforation while also ruling out similar conditions.

There might be a few steps before you undergo certain tests, such as fasting and only drinking clear liquids hours before the test. Doctors might also suggest either injection or ingestion of laxatives or solutions that can make your test results appear clearer. 

How is ulcerative colitis treated?

If you have ulcerative colitis, your treatment options may vary from drug therapy to surgery. Your treatment depends on the severity of your condition, and the effects may be different from others.

  • Anti-inflammatory drugs (1st line treatment)

Physicians typically recommend that most people with ulcerative colitis take anti-inflammatory drugs by mouth or use them as an enema or suppository. The drug the physician chooses to prescribe will depends on the affected area of your colon. Anti-inflammatory drugs can either be aminosalicylates or corticosteroids. 

  • Immunosuppressants 

Medicines that work to lessen immune system activities. Immunosuppressants serve to treat mild reactions or to maintain remission if your symptoms fail to respond to other treatments.  

  • Biologics

Biologics such as infliximab, vedolizumab, and ustekinumab are drugs that target proteins from your immune system. Doctors will usually recommend this form of medication if you are not responding or cannot tolerate other ulcerative colitis  treatments.

  • Surgery 

If you have ulcerative colitis, then there’s a chance that you will undergo J-pouch surgery. Surgeons create a J-shaped pouch from the ends of your small intestine, and attach it to your anus so you can excrete like usual. However, you can also have an ileal stoma. A stoma is a surgery in which your bodily waste will pass through an opening in your abdomen rather than your anus. 

Get personalized help

There’s a lot to discuss about ulcerative colitis. If you’re looking for more information about this chronic disease, Better Health’s experts can offer personalized advice and recommendations. Call us at 415-575-8444 to consult a Better Health expert today. 

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