Ulcerative Colitis
Ulcerative colitis (UC) causes irritation and ulcers (open sores) in the large intestine. It belongs to a group of conditions called inflammatory bowel disease (IBD). It often causes diarrhea with blood, cramping and urgency. Sometimes these symptoms can wake a person up at night to go to the bathroom as well.
Causes
Researchers think the cause of ulcerative colitis is complex and involves many factors.
They think it’s probably the result of an overactive immune response.
The immune system’s job is to protect the body from germs and other dangerous substances.
But, sometimes your immune system mistakenly attacks your body, which causes inflammation and tissue damage.
Symptoms
Ulcerative colitis symptoms often get worse over time. In the beginning, you may notice:
Diarrhea or urgent bowel movements.
Abdominal (belly) cramping.
Tiredness.
Nausea.
Weight loss.
Anemia (reduced number of red blood cells).
Later you may also have:
Blood, mucous, or pus in bowel movements.
Severe cramping.
Fever.
Skin rashes.
Mouth sores.
Joint pain.
Red, painful eyes.
Liver disease.
Loss of fluids and nutrients.
Diagnosis
Blood tests: Your blood can show signs of infection or anemia. Anemia is a low level of iron in your blood. It can mean you have bleeding in the colon or rectum.
Stool samples: Signs of infection, parasites (tiny organisms that can live in a person’s body), and inflammation can show up in your poop.
Imaging tests: Your healthcare provider may need a picture of your colon and rectum. You may have tests including a magnetic resonance imaging (MRI) scan or computed tomography (CT) scan.
Endoscopic tests: An endoscope is a thin, flexible tube with a tiny camera. Specialized doctors can slide the endoscope in through the anus to check the health of the rectum and colon. Common endoscopic tests include colonoscopy and sigmoidoscopy.
Treatment
Aminosalicylates: For mild to moderate ulcerative colitis, your healthcare provider may prescribe sulfasalazine. Let your provider know if you’re allergic to sulfa. He or she can prescribe a sulfa-free aminosalicylate instead, such as mesalamine. The medications come in both pill form and enema or suppository form, which can better reach the inflammation low down in the colon or rectum.
Corticosteroids: If you have a severe form of ulcerative colitis, you may need a corticosteroid such as prednisone or budesonide. Because corticosteroids have serious side effects, healthcare providers only recommend them for short-term use. Other medications will be used to help maintain the remission.
Immunomodulators: Your healthcare provider may recommend an immunomodulator. These medicines include 6-mercaptopurine. These medications help calm the overactive immune system.
Biologics: Biologics treat moderate to severe ulcerative colitis by targeting parts of the immune system to quiet it down. Medications like infliximab, adalimumab, golimumab, certolizumab pegol, vedolizumab, and ustekinumab are biologics. Janus kinase (JAK) inhibitors: Drugs like tofacitinib stop one of your body’s enzymes (chemicals) from triggering inflammation.