Ulcerative colitis – Symptoms, causes, and treatment

Ulcerative colitis is a type of inflammatory bowel disease that causes lasting inflammation and ulcers in the lining of the large intestine or the colon, in other words, the digestive tract. 

Due to this inflammation, tiny ulcers (sores) are formed in the rectum and gradually spread upward to the colon. The inflammation also causes rapid movement of the contents of the bowel, resulting in urgent trips to the bathroom 

Although incurable, the symptoms of ulcerative colitis can be put on long-term remission with proper treatment and medication.

While it can affect people of all ages, most people with ulcerative colitis are diagnosed between the ages of 15 to 35 years. 

Signs and symptoms
Depending on the severity of inflammation in the colon and various other factors, the signs and symptoms of ulcerative colitis vary among individuals.

The symptoms of the disease develop gradually and can be mild in the beginning or there can be no symptoms observed at all.

Some common signs and symptoms are as follows:

  • Diarrhea (often with blood and pus)
  • Abdominal pain and cramps
  • Rectal pain
  • Rectal bleeding
  • Inability to defecate, despite the urgency
  • Weight loss
  • Tiredness
  • Fever

Causes and risk factors
The exact cause of ulcerative colitis is not known; experts believe that an overactive immune system can be the main cause of the disease. 

According to research studies, the following are the risk factors ulcerative colitis.

  • Genes
    Ulcerative colitis could be in the genes that one has inherited from either of their parents.  
  • Immune disorder
    In the case of autoimmune diseases such as ulcerative colitis, the immune system mistakenly attacks its own body—in this case, the colon—and leads to its inflammation, which results in the symptoms of the disease.
  • Environmental factors
    Bacteria, viruses, and antigens in the environment might increase one’s chances of developing ulcerative colitis.

People using nonsteroidal anti-inflammatory medicines, antibiotics, or birth control pills have higher chances of getting infected by the disease.  

Since ulcerative colitis cannot be cured, the treatment aims to reduce the inflammation of the colon so that the symptoms do not flare-up. 

  • Medication
    The doctor may prescribe several types of medications to curb inflammation in the colon, which will help alleviate the symptoms. 
  • Diet and nutrition
    Even though food doesn’t seem to be the major cause of ulcerative colitis, following an appropriate diet will help to prevent the symptoms from rising again. Eating a low-fat diet and intaking more vitamin C and fiber may provide long-term relief from flare-ups. 
  • Surgery
    The doctor will suggest surgery if one is not positively responding to the medication, or the symptoms are getting worse. 

Ulcerative colitis’ surgery involves the removal of the colon and rectum or only the colon. Instead, a new pathway for the waste is created through a small opening in the abdominal wall or redirected back through the end of the rectum.  

To remove the entire colon, the surgeon makes a small opening in the belly wall and attaches a bag (pouch) there. They will then bring the tip of the patient’s lower small intestine through the opening in the belly so as to allow the waste to pass and get collected in a pouch. After the surgery, the patient needs to wear the pouch all the time. 

However, these days due to medical advancements, permanent opening in the belly wall need not be made. The surgeon instead removes the colon or rectum and uses the patient’s small intestine as an internal pouch that will be connected to the anus.