Alternative Names non-specific ulcerative colitis, granulomatous colitis
Definition Ulcerative colitis is a chronic inflammatory disease of the bowel with ulceration and episodes of bloody diarrhoea. It may occur at any age and in both sexes, but it is most common between the ages of 15 and 40.
What is going on in the body? In ulcerative colitis, tissue lining the bowel is inflamed and destroyed by the immune system's response to certain proteins, or antigens. Segments of the whole bowel are affected starting at the rectum. These segments become inflamed and may form abscesses in the lining of the large intestine. This leads to bloody diarrhoea.
What are the signs and symptoms of the disease? Symptoms vary depending on the type of ulcerative colitis:
bloody diarrhoea, with up to 10 to 20 bowel movements a day
pain in the abdomen that improves after having a bowel movement
What are the causes and risks of the disease? The cause of ulcerative colitis is unknown. It may be related to an abnormal immune response in the gastrointestinal tract, or infection from a bacteria. Stress was once thought to be a cause. However, studies have shown that stress increases the severity of the attack but doesn't cause the condition. No specific diet has been singled out as a cause of ulcerative colitis, but experts have noted an association with diets high in unsaturated fats and unrefined sugars. A person is at higher risk if they have a family history of ulcerative colitis.
What can be done to prevent the disease? There are no specific preventive measures.
How is the disease diagnosed? To diagnose ulcerative colitis, a medical history is taken and a physical examination is done. Tests that may be done are:
laboratory tests on the stool to check for blood
a special X-ray of the bowel known as a barium enema
a sigmoidoscopy or a colonoscopy. During these tests, a flexible scope is inserted into the bowel through the rectum. The doctor can see how the lining of the bowel looks, and take a biopsy as needed.
blood tests
What are the long-term effects of the disease? People with ulcerative colitis may have:
inflammation of the joints, eyes, skin, and bile ducts
peritonitis, or inflammation of the abdominal cavity lining
What are the risks to others? There are no risks to others.
What are the treatments for the disease? Treatment of ulcerative colitis varies depending on the intensity and location of the inflammation, response to previous treatments, and the impact that the illness has on the person's life. The goals are to control inflammation, replace nutritional losses and blood volume, and prevent complications. Treatment may include:
hospitalisation in severe cases
corticosteroids. These are mostly used to treat people with moderate to severe ulcerative colitis. These may be given by mouth, such as oral prednisone. Corticosteroids may also given as rectal suppositories, such as hydrocortisone, or intravenously, such as methylprednisolone.
intravenous fluids to correct fluid and electrolyte imbalances caused by frequent diarrhoea
dietary restriction, such as only drinking clear liquids, to allow the bowel to rest
medications such as sulphasalazine, mesalamine or olsalazine.
surgery with resection of the entire bowel and rectum, which can lead to a cure of ulcerative colitis. Surgery greatly enhances the quality of life among people who have severe symptoms.
What are the side effects of the treatments? Side effects of medications used to treat ulcerative colitis vary, but can include:
nausea
vomiting
indigestion
lethargy
Side effects to other treatments may include:
chronic abdominal pain
chronic blood loss that results in anaemia
bowel perforation
infection
What happens after treatment for the disease? Many people have a complete remission after one episode, but most will have recurrences of ulcerative colitis.
How is the disease monitored? A person should have a colonoscopy to monitor their disease.
Author: David J. Craner, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
