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Ulcerative Colitis or UC is a type of inflammatory bowel disease that is found in the Large Intestines. On examination – one of the most often findings is ulcers in the intestines.

UC is often confused with irritable bowel syndrome which is a less serious condition or another type of Inflammatory Bowel Disease called Crohn’s Disease.

This condition has periods of time with extreme symptoms and other times of almost none at all. Remission occurs with time and treatment. Reoccurance is also rather unavoidable

The specific cause is unknown but some genetic risk may be present. Diet is not seen as a risk factor but for some who have ulcerative colitis a modified diet has been somewhat beneficial.  Others insist that they have seen certain foods aggravate their symptoms. If this is the case, a food diary is a must.

Much of the treatment of this disease points to an autoimmune disease however, no specific link has been made. Ulcerative Collitis is often diagnosed between the ages of 10 and 25.

Possible Causes

–  Diet
–  Genetic
–  Autoimmune
–  Other environment
–  Bacterial or infectious
–  Other

Symptoms

1.)  GI or Intestinal Symptoms

–  Diarrhea
–  Diarrhea with mucous
–  Diarrhea with blood
–  Weight loss
–  Abdominal pain
–  Abdominal pressure
–  Cramps
–  Bloating

2.)  Additional symptoms

–  Aphthous ulcers in mouth
–  Joint pain in back, hands, feet, others
–  Fever
–  Nausea
–  Vomiting
–  Fatigue
–  Muscle Aching
–  Headaches
–  Others

Classifications according to Location

1.)   Proctitis – Inolvment of rectum only
2.)  Proctosigmoiditis – Involvement of just above the rectum
3.)  Left-Sided colitis –   Involvement of descending colon
4.)  Pancolitis –  Involvement of entire colon to the small intestine

Classifications according to Severity

Mild disease

–  Fewer bowel movements
–  With or without blood
–  Normal blood work
–  Abdominal pain or cramping

Moderate disease

–  4+ stools a day
–  Possible anemia
–  Moderate abdominal pain
–  Fever

Severe disease

–  6+ stools a day
–  Blood in stools
–  Fever
–  Elevated heartbeat
–  Abnormal labs
–  Probable anemia

Fulminant disease

–  10+ stools a day
–  Blood in stool
–  Abdominal tenderness
–  Abdominal bloating
–  Abdominal distention
–  Very sick
–  Blood transfusion may be needed
–  May be very serious
–  Treatment is necessary or death can occur

Complications

1.)  Increased risk of colorectal cancer

2.)  Primary Sclerosing Cholangitis – increased risk

Diagnosis

1.)  Blood work
2.)  X-ray
3.)  Urinalysis
4.)  Stool culture
5.)  Colonoscopy
6.)  Biopsies

Treatment

Medications

1.)  Aminosalicylates

.  Mesalazine   [Asacol, Pentasa]
.  Acute Pancreatitis [Sulfasalazine]
.  Balsalazide [Colazal]
.  Olsalazine  [Dipentum]

2.)  Corticosteroids

.  Prednisone
.  Budesonide  [Entocort]
.  Hydrocortisone
.  Cortisone
.  Methylprednisolone

3.)  Immunosuppressive Drugs

.  Azathioprine
.  Mercaptopurine
.  Methotrexate

4.)  TNF Inhibitors

.  Infiximab

5.)  Enema treatment

.  Mesalazine enema  [Rowasa]
–  Mesalazine suppoitories and foam
–  Hydrocortisone enema

6.)  Folic supplementation due to decreased amount due to medication action

Surgery

–  Surgery of large intestines often can cure ulcerative colitis
–  This treatment is seen with worse symptoms

Diet

.   Modifications may be beneficial
.   Possible lactose intolerance
.   Carbohydrate diet
.   Vitamin A
.   Vitamin C
.   Vitamin E
.   Fish oils