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Ulcerative Colitis


Topic Overview

Lower digestive system

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Ulcerative colitis and Crohn's disease are the most common types of inflammatory bowel disease. Ulcerative colitis affects only the colon and rectum. Crohn's can affect any part of the digestive tract. To learn more about Crohn's disease, see the topic Crohn's Disease.

What is ulcerative colitis?

Ulcerative colitis is a disease that causes inflammation and sores (ulcers) in the lining of the large intestine (colonClick here to see an illustration.). It usually affects the lower section (sigmoid colon) and the rectum. But it can affect the entire colon. In general, the more of the colon that's affected, the worse the symptoms will be.

The disease can affect people of any age. But most people who have it are diagnosed before the age of 30.

What causes ulcerative colitis?

Experts aren't sure what causes it. They think it might be caused by the immune system overreacting to normal bacteria in the digestive tract. Or other kinds of bacteria and viruses may cause it.

You are more likely to get ulcerative colitis if other people in your family have it.

What are the symptoms?

The main symptoms are:

  • Belly pain or cramps.
  • Diarrhea.
  • Bleeding from the rectum.

Some people also may have a fever, may not feel hungry, and may lose weight. In severe cases, people may have diarrhea 10 to 20 times a day.

The disease can also cause other problems, such as joint pain, eye problems, or liver disease.

In most people, the symptoms come and go. Some people go for months or years without symptoms (remission). Then they will have a flare-up. About 5 to 10 out of 100 people with ulcerative colitis have symptoms all the time.1

How is ulcerative colitis diagnosed?

Doctors ask about the symptoms, do a physical exam, and do a number of tests. Testing can help the doctor rule out other problems that can cause similar symptoms, such as Crohn's disease, irritable bowel syndrome, and diverticulitis.

Tests that may be done include:

  • A colonoscopy. In this test, a doctor uses a thin, lighted tool to look at the inside of your entire colon. At the same time, the doctor may take a sample (biopsy) of the lining of the colon.
  • Blood tests, which look for infection or inflammation.
  • Stool sample testing to look for blood, infection, and white blood cells.

How is it treated?

Ulcerative colitis affects everyone differently. Your doctor will help you find treatments that reduce your symptoms and help you avoid new flare-ups.

If your symptoms are mild, you may only need to use over-the-counter medicines for diarrhea (such as Imodium). Talk to your doctor before you take these medicines.

Many people need prescription medicines, such as aminosalicylates, steroid medicines, or other medicines that reduce the body's immune response. These medicines can stop or reduce symptoms and prevent flare-ups.

Some people find that certain foods make their symptoms worse. If this happens to you, it makes sense to not eat those foods. But be sure to eat a healthy, varied diet to keep your weight up and to stay strong.

If you have severe symptoms and medicines don't help, you may need surgery to remove your colon. Removing the colon cures ulcerative colitis. It also prevents colon cancer.

How will ulcerative colitis affect your life?

People who have ulcerative colitis for 8 years or longer also have a greater chance of getting colon cancer. The longer you have had ulcerative colitis, the greater your risk.2 Talk to your doctor about your need for cancer screening. These tests help find cancer early, when it is easier to treat.3

Ulcerative colitis can be hard to live with. During a flare-up, it may seem like you are always running to the bathroom. This can be embarrassing. And it can take a toll on how you feel about yourself. Not knowing when the disease will strike next can be stressful.

If you are having a hard time, seek support from family, friends, or a counselor. Or look for a support group. It can be a big help to talk to others who are coping with this disease.

Frequently Asked Questions

Learning about ulcerative colitis:

  • What is ulcerative colitis?
  • What causes it?
  • How severe can it be?
  • What are the symptoms?

Being diagnosed:

  • What tests are used to diagnose ulcerative colitis?
  • How does a colonoscopy help diagnose it?
  • How does a stool analysis help diagnose it?
  • How does a barium enema X-ray help diagnose it?

Getting treatment:

  • How is ulcerative colitis treated?
  • What medicines are used?
  • What types of surgery are used?
  • Click here to view a Decision Point.Should I have surgery to cure ulcerative colitis?
  • Are there other treatments?

Ongoing concerns:

  • When should I see a doctor?
  • What can I do at home to treat symptoms?
  • Click here to view an Actionset.How can I eat a healthy diet when I have ulcerative colitis?
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