Ulcerative Colitis

What is ulcerative colitis?

Ulcerative colitis is an inflammation in the lining of the large intestine (colon) and rectum.

How does it occur?

The cause of ulcerative colitis is not known. It appears to be a problem with the immune system. The disease is not caused by emotional distress or sensitivity to certain foods. However, these things may trigger symptoms in some people who have colitis. The stress of living with ulcerative colitis may also help make symptoms worse.

What are the symptoms?

The symptoms usually come and go. They may include:

• diarrhea, usually with blood or mucus
• crampy pain in your lower belly
• fever
• weight loss
• tiredness.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you.

Tests you may have are:

• blood tests
• barium enema X-ray
• sigmoidoscopy or colonoscopy.

Sigmoidoscopy and colonoscopy are procedures for looking inside your large intestine with a flexible lighted tube. A biopsy can be done during these procedures. For the biopsy, your provider will take a sample of tissue from the lining of the colon. The sample will be examined in the lab.

How is it treated?

Your healthcare provider may advise a special diet high in protein and calories. Depending on your condition, you may need to have a high-fiber or low-fiber diet.

Medicines often used to treat ulcerative colitis are:

• mesalamine or sulfasalazine
• steroids (hydrocortisone or methylprednisolone).

Drugs that suppress the immune system may be prescribed. Azathioprine is an example of this type of drug.

In some cases you may need to stay in the hospital. Your treatment may include:

• IV (intravenous) feeding to replace lost nutrients and fluids
• blood transfusions to restore lost blood
• antibiotics to treat any possible infection
• nasogastric suction to remove stomach juices through a tube passed through your nose (this allows the stomach and intestines to rest).

In severe cases, when medicines fail to control the symptoms, surgery may be needed. Sometimes part of the colon needs to be removed. It may mean complete removal of the large intestine, followed by an operation called a permanent ileostomy. When this operation is done, the ileum (the lower part of the small intestine) is brought through a cut in the abdominal wall and formed into an opening to allow bowel movements to collect in a small bag attached to the skin. Sometimes, if the rectum and anus are not affected, the small intestine can be connected to the rectum. This can let you keep passing bowel movements through the anus, so that there is no need for an ileostomy bag.

How long will the effects last?

Some people have an attack of colitis and then may not have any symptoms for months or even years. However, in most cases the symptoms eventually return. Ulcerative colitis can usually be controlled with medicines and diet, but you may need surgery if your symptoms are severe.

How can I take care of myself?

• Follow the treatment plan your healthcare provider prescribes. You and your healthcare provider will need to be partners in controlling your symptoms. Ask how you can take care of yourself at home. Also ask when you should call or see your provider about new or worsening symptoms as well as how often you should have regular checkups.
• Follow the diet recommended by your provider. Avoid food and drinks that make your symptoms worse, such as milk products for some people.
• When you have diarrhea, rest your bowel by drinking only clear liquids such as water, juice, tea, and bouillon for a few hours. It is important to drink small amounts often so you don't get dehydrated. Suck on ice chips if you feel too nauseated to drink anything. Do not eat solid foods if they cause cramps.
• Learn to use deep breathing exercises and other relaxation techniques when you feel stress.
• Make sure you get enough rest and sleep.
• Learn to recognize the signs of recurrence early so you can get early treatment.

Because chronic ulcerative colitis may be associated with cancer of the intestine, make sure you have regular checkups. Follow your healthcare provider's recommendations for colon cancer screening exams.

For more information, contact:

Crohn's and Colitis Foundation of America
Phone: 800-932-2423
Web site: http://www.ccfa.org.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File gase4039.htm Release 13/2010