Ulcerative colitis is characterized by inflammation in the lower gastrointestinal track and the development of open sores and/or ulcers within the large intestine. Although onset is most common between the ages of 15 and 30 years, the disorder can develop at any age.
People with ulcerative colitis experience occasional flareups, followed by periods of remission. Flareups can last for days or weeks, with remission lasting months or sometimes years. Patients’ flareups may move from mild to more serious and back again. In some people the disease becomes more advanced, spreading to other areas of the colon.
What are the main symptoms?
The most common symptoms of ulcerative colitis are abdominal cramping and pain with frequent bouts of diarrhea. Stool may contain mucus, blood, and/or pus. Other symptoms include fatigue, fevers, loss of appetite, and nausea.
Because people with the condition have difficulties absorbing enough fluids and nutrients, they often experience weight loss. Since people with ulcerative colitis experience chronic bleeding from ulcerated and inflamed intestinal tissue, this can also trigger anemia. Children who have the condition often experience growth delays. Other complications of ulcerative colitis include bone loss; inflammation of the skin, joints, and eyes; toxic megacolon; higher risk of blood clots; and in rare cases, liver disease.
What causes ulcerative colitis?
Though scientists have yet to pinpoint the precise cause, many attribute ulcerative colitis to immune system problems, which may also have a genetic basis.
Research indicates that ulcerative colitis is an autoimmune condition—a condition where the immune system malfunctions, mistakenly attacking healthy tissue and causing inflammation. In ulcerative colitis, it’s thought by some researchers that the immune system mistakes helpful colon bacteria for pathogenic ones. Other researchers think the condition occurs when the immune system is triggered to fight a true infection but fails to stop once the infection has been eradicated.
What are the potential complications?
In rare cases, ulcerative colitis can cause a life-threatening complication called toxic megacolon.
The large intestine comprises the lower region of the digestive tract, including the appendix, colon, and rectum. The large intestine completes digestion by absorbing water and finally expelling waste from the rectum. In extreme UC cases, the disease can disrupt these normal processes, causing the large intestine to malfunction.
Ulcerative colitis and other types of inflammatory bowel disease can trigger a widening of the large intestine. As the colon expands, dilates and distends, it becomes unable to perform its primary function. As a result, toxic megacolon can become life-threatening within a few days of onset. When the body is unable to expel gas and feces, the colon can rupture. Rupture and release can cause bacteria to leak from the intestine into the abdomen, which can cause dangerous infections and ultimately death.
The main symptoms of toxic megacolon include pain, bloating, and tenderness in the abdomen, fever, painful bowel movements and/or profuse or bloody diarrhea, rapid heart rate, and shock. Symptoms can come on suddenly, and when they develop, patients must immediately seek medical attention.
The condition usually requires hospitalization and surgery to correct. Caregivers administer fluids to prevent shock, which can trigger a life-threatening decrease in blood pressure. If the colon has been perforated, the patient may need a colectomy: a surgical procedure involving a partial or complete removal of the colon, followed by a course of antibiotics to prevent sepsis, another potentially fatal complication.
People with ulcerative colitis also have an increased risk of developing osteoporosis. Osteoporosis causes bones to become weak and brittle, making people with the condition more susceptible to breaks and fractures. Osteoporosis is not directly caused by ulcerative colitis, but by prolonged use of corticosteroid medications often used to treat it. In addition, specialists also attribute osteoporosis in ulcerative colitis patients to nutritional deficiencies caused by the need to avoid dairy products to avoid flareups.
The growth and development of children affected by ulcerative colitis is often inhibited, either by the condition itself or the side effects of prescribed treatments. Young people, children, and infants diagnosed with the condition must have their height and weight closely monitored by health professionals at regular intervals depending on their age, their particular symptoms, and the treatments they’re undergoing. Ulcerative colitis or the treatments for it can also delay the onset of puberty in adolescents.
Is there a cure?
The only cure for ulcerative colitis is colon removal, which has serious health implications. The most common first-line treatment is anti-inflammatory drugs such as corticosteroids, followed by immune system suppressors such as azathioprine and mercaptopurine. Though there’s no evidence that one’s diet causes ulcerative colitis, some foods can aggravate symptoms, especially during flareups, so many patients find it helpful to eliminate certain foods from their diets.
When ulcerative colitis is diagnosed and treated early, this slows the condition’s progression, minimizing symptoms and maximizing periods of remission. The earlier a person begins treatment, the more effective it is likely to be. A 2014 study revealed that patients in remission who stick to their treatment plans reduce the risk of future flareups by 40%.