Ulcerative Colitis (UC)

Dr. Robert Schiffer M.D.

Ulcerative Colitis (UC)

Ulcerative colitis (UC) is a disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. It is one of a group of diseases called inflammatory bowel disease. UC can happen at any age, but it usually starts between the ages of 15 and 30. It tends to run in families. The most common symptoms are pain in the abdomen and blood or pus in diarrhea. Other symptoms may include

  • Anemia
  • Severe tiredness
  • Weight loss
  • Loss of appetite
  • Bleeding from the rectum
  • Sores on the skin
  • Joint pain
  • Growth failure in children

About half of people with UC have mild symptoms. Doctors use blood tests, stool tests, colonoscopy or sigmoidoscopy, and imaging tests to diagnose UC. Several types of drugs can help control it. Some people have long periods of remission, when they are free of symptoms. In severe cases, doctors must remove the colon.

The goals of treatment are to:

  • Control the acute attacks
  • Prevent repeated attacks
  • Help the colon heal

You may need to be treated in the hospital for severe attacks. Your doctor may prescribe corticosteroids. You may be given nutrients through a vein (IV line).

DIET AND NUTRITION

Certain types of foods may worsen diarrhea and gas symptoms. This problem may be more severe during times of active disease. Diet suggestions include:

  • Eat small amounts of food throughout the day.
  • Drink plenty of water (drink small amounts throughout the day).
  • Avoid high-fiber foods (bran, beans, nuts, seeds, and popcorn).
  • Avoid fatty, greasy or fried foods and sauces (butter, margarine, and heavy cream).
  • Limit milk products if you are lactose intolerant. Dairy products are a good source of protein and calcium.

STRESS

You may feel worried, embarrassed, or even sad or depressed about having a bowel accident. Other stressful events in your life, such as moving, or losing a job or a loved one can cause digestive problems.

Ask your doctor or nurse for tips on your to manage your stress.

MEDICINES

Medicines that may be used to decrease the number of attacks include:

  • 5-aminosalicylates such as mesalamine or sulfazine, which can help control moderate symptoms. Some forms of the drug are taken by mouth; others must be inserted into the rectum.
  • Medicines to quiet the immune system.
  • Corticosteroids such as prednisone. They may be taken by mouth during a flare-up or inserted into the rectum.
  • Biologic therapy, if you do not respond to other drugs.
  • Acetaminophen (Tylenol) may help relieve mild pain. Avoid drugs such as aspirinibuprofen (Advil, Motrin), or naproxen(Aleve, Naprosyn). These can make your symptoms worse.

SURGERY

Surgery to remove the colon will cure ulcerative colitis and removes the threat of colon cancer. You may need surgery if you have:

  • Colitis that does not respond to complete medical therapy
  • Changes in the lining of the colon that can lead to cancer
  • Severe problems, such as rupture of the colon, severe bleeding, or toxic megacolon

Most of the time, the entire colon, including the rectum, is removed. After surgery, you may have:

  • An opening in your belly called the stoma (ileostomy). Stool will drain out through this opening.
  • A procedure that connects the small intestine to the anus to gain more normal bowel function.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases