Ulcerative Colitis

While the exact cause is unknown, experts believe several factors may be linked to ulcerative colitis, including:

• Family history - Having a family member with the disease increases your risk
• Overactive immune response - It may start as a response to viruses or bacteria, but the immune system never shuts off, causing chronic inflammation
• Age - The disease can occur at any age but is often diagnosed between the ages of 15-30 and 60+
• Race and ethnicity - Ulcerative colitis is more common in white people and those of Jewish ancestry

Types of ulcerative colitis are categorized by location and the extent of inflammation. Types include:

Ulcerative proctitis

Inflammation is limited to the rectum. Ulcerative proctitis typically affects less than six inches of the rectum.

Left-sided colitis (or distal ulcerative colitis)

Continuous inflammation affects the distal colon (the part of the colon that travels down the left side of the abdomen toward the rectum). Proctosigmoiditis is a form of life-sided colitis that affects the sigmoid colon (the last part of the colon that connects to the rectum).

Extensive colitis (or pancolitis)

Inflammation and ulcers cover the entire length of the colon.

Ulcerative colitis symptoms

Symptoms vary and may come and go. But people who experience the following symptoms should discuss them with their doctor:

• Loose and urgent bowel movements
• Blood or pus in the stool
• Abdominal cramps and pain
• Persistent diarrhea accompanied by abdominal pain and blood in the stool
  

Beyond the intestine, ulcerative colitis can cause other side effects, including:

• Anemia (low red blood cell count)
• Appetite loss
• Fatigue or low energy
• Fever
• Nausea
• Weight loss

A physical exam and a series of tests are performed to diagnose ulcerative colitis. Tests may include:

• Blood tests to check for anemia (low blood counts) and the severity of inflammation
• Stool tests to detect infections or blood in the stool
• Colonoscopy to examine the colon (the lower portion of your large intestine), with or without dye contrast
• Biopsy to collect a small piece of tissue from the inside of the intestine for further testing
• Imaging tests such as x-rays, CT scans or MRIs to examine areas that can’t be easily seen by endoscopy or colonoscopy

Mercy gastroenterologists treat ulcerative colitis with medication, nutritional therapy and sometimes bowel surgery.

Medication

Medications used to treat ulcerative colitis include:

• Anti-inflammatory drugs to reduce swelling
• Biologics to neutralize proteins that cause inflammation
• Immunosuppressant drugs to suppress an overly active immune system and decrease inflammation

Medical Nutrition Therapy

Mercy dietitians can assess the nutritional status of people with ulcerative colitis and recommend dietary or lifestyle changes to improve their symptoms. A food diary can be used to identify foods that trigger ulcerative colitis symptoms.

Surgery

Surgery may be needed if medication and nutrition therapy aren’t controlling ulcerative colitis symptoms — or if complications like severe bleeding occur. Mercy offers a variety of surgical treatment options, including minimally invasive procedures to repair or remove damaged areas of the GI tract.

J-Pouch Surgery

J-pouch surgery is also known as Ileal pouch-anal anastomosis (IPAA) surgery. This procedure restores the ability to eliminate waste normally after the removal of the entire large intestine (colon and rectum).