Ulcerative colitis is a form of Inflammatory Bowel Disease (IBD) that causes inflammation of the colon and is estimated to affect almost a million Americans nationwide.  While ulcerative colitis and Crohn’s disease form the cornerstone of IBD and affect the bowel, ulcerative colitis pinpoints the colon, whereas Crohn’s disease can target either the colon or small intestine.

What is it?

Ulcerative colitis is a chronic disease that results in inflammation of the colon’s innermost layer, called the colon mucosa, where small ulcers develop.  These tears, or ulcers, often occur along the entire length of the colon to the rectum, and produce a discharge of blood and mucus. It is widely thought that the disease is marked by an abnormal response of the immune system: when the body senses pathogens in the bowel the immune system attacks the affected area in an effort to rid the body of any foreign proteins, such as viruses or bacteria. The body unknowingly is often attacking benign bacteria in the bowel. This exaggerated response leads to ulcers in the bowel lining, and inflammation that plagues many IBD sufferers.

Symptoms of Ulcerative Colitis

Because of this inflammation, the disease is characterized by abdominal pain, diarrhea, and the presence of bloody stool, yet the severity of these effects differs from patient to patient.  In rare instances, ulcerative colitis can be debilitating. Although presently there is no cure, several medications and therapies exist that can lessen the symptoms of the disease and many patients experience long periods of remission.

In addition to abdominal pain and diarrhea (with or without the presence of blood), several other hallmarks of the disease may be present. Many patients experience urgency and frequency in having to use the bathroom. In severe cases, ulcerative colitis patients may eliminate their bowels upwards of 20 times a day. This loss of nutrients can lead to fatigue, weight loss, and loss of appetite. Additionally, some patients experience joint problems, anemia, and skin lesions among other complications.

Causes of Ulcerative Colitis

Doctors and scientists still do not know what causes ulcerative colitis, and there is no one standard viewpoint. Many professionals think it may be inherited, while some think the disease could be a byproduct of the environment.  At one time the culprit was thought to be nutrition or stress, but both of these theories have been debunked.  Although the exact causes are not known, one thing is for certain: the body’s immune system is responding incorrectly. Because of this auto-immune response, doctors work with patients on therapies to regulate their immune systems to improve their quality of life.

Treatment Options

Many doctors adhere to “step therapy”, where they prescribe medications that have long been used to treat ulcerative colitis and often have milder side effects.  If that particular therapy does not successfully coax the patient into remission, the doctor may “step up” treatment and utilize stronger medications.

The most common treatment options include anti-inflammatory medications called Aminosalicylates (5-ASA). This class of medication often produces fewer side effects and is used to treat mild to moderate cases of ulcerative colitis. If Aminosalicylates prove unsuccessful, many patients move to corticosteroids which assist in suppressing the immune response. More progressive treatment options follow, and include the use of immune modifiers and, most recently, biologic therapies which alter the immune response of the body. In up to one-third of cases medical therapy may not be sufficient to control the effects of ulcerative colitis, and patients turn to a surgical solution which often includes the removal of the colon, known as a colectomy.

Although presently is no cure, significant medical advances have been made in the last twenty years in treating IBD.  Most patients with ulcerative colitis lead active and productive lives by teaming with their healthcare provider to manage their disease.