Ulcerative Colitis

There are a number of causes of abdominal illnesses, and one of the ones that is quite serious – treatable, but less common – is ulcerative colitis. Dr Joe Kosterich talks about ulcerative colitis, including what it is, what its symptoms are, how it is diagnosed and how it is treated.
Inflammatory bowel disease is a term that covers a number of conditions, including Crohn’s disease and ulcerative colitis. Ulcerative colitis is a condition that affects mainly the large intestine. The condition is so called because literally you get ulcers on the lining of the colon – so ‘ulcerative’, necessarily, and ‘colitis’, inflammation of the colon.
When one has a look into the colon with a scope, one can see that the lining of the gut, which is a mucosa, has lost some of its surface. This is where the ulceration comes from. It mainly affects the large bowel rather than the small bowel.
It’s not a common condition, but it can be quite debilitating for sufferers. It’s more common in females than in males, and most typically starts somewhere for people in their 20s or 30s. So it’s not an old people’s disease; it’s something that generally affects people who are quite young.
There can be genetic tendencies, but nobody really knows exactly what causes it. It’s not related, for example, to viruses, it’s not a side effect of medications, it doesn’t follow on from any trauma to the gut. Some of the theories include that it might have an autoimmune background, but, as I’ve said, nobody absolutely knows.
The symptoms of ulcerative colitis are typically abdominal pain, nausea for some people, cramping in the gut, and diarrhoea. In addition to that, there can be quite a lot of blood passed with the diarrhoea, so blood in the stools is one of the other causes. Generally people will start to lose their appetite, and they may lose some weight as well.
If these sort of symptoms go for a day or two, that can be part of a food poisoning or a diarrhoeal type illness. But the thing with ulcerative colitis is that the symptoms can persist for a longer period of time. They’re not necessarily all there together at one time. It can go in bursts – people can be unwell for some days or weeks, then it can settle, then it can come back. People can get some symptoms – they might get some diarrhoea, then that might settle down, and they might then get some nausea or other symptom.
When you have these sorts of symptoms, particularly if there is any blood in the bowel motion, it is important to go see your doctor.
Diagnosis of ulcerative colitis will generally be done through a colonoscope. This is a test where a tube is passed into the bowel and one has a look literally like through a telescope. Some blood tests might also be done to look for other causes, but there isn’t a blood test, as such, for ulcerative colitis.
Once the diagnosis is confirmed, then there are medications that can be used to control the condition. These will generally be long-term – perhaps life-long – medications that need to be taken. They usually work by settling down inflammation along the gut. They are not anti-diarrhoeal tablets or anti-nausea tablets.
There are also enemas that can be used for people who have particular symptoms and pain around the anus or rectal area. In more severe cases, surgery can also be done, and there are instances where people may need to have some, or indeed all, of the large intestine removed. Fortunately that’s not the case for the majority, and with the passage of years, there’ve been some improvements in drug treatments. But some people may still require surgery.
For most people, the condition can be controlled quite satisfactorily. That doesn’t mean that it may not play up from time to time, but it does mean that rather than having ongoing symptoms, the symptoms will tend to be hopefully milder and certainly less frequent (which is one of the markers of treatment). Unfortunately, total absence of any symptoms is not always something that can be achieved.
Ulcerative colitis is not a pleasant condition. Fortunately, it can be controlled these days, so it’s not generally a fatal condition and people can live quite long lives with it. It is fair to say that it can be disruptive of life, but the symptoms can be controlled so that any disruption to one’s overall life can certainly be minimised. There is no specific diet to follow, but people generally find what does and doesn’t agree with them, and there are medications available that can have a very beneficial effect in terms of controlling the condition.

More information

For more information on inflammatory bowel disease, including how the digestive system works, types of IBD and useful videos, see Inflammatory Bowel Disease (IBD).