Ulcerative colitis

What is ulcerative colitis?

Ulcerative colitis (UC) is a form of inflammatory bowel disease that affects the large bowel or colon. It is thought to relate to a maladapted gut immune system that leads to uncontrolled inflammation in the large bowel. It can be mild and only involve a short segment of the bowel or can be more severe and affect the whole colon. There tends to be a dual peak in the incidence affecting people 15-25 years of age and also patients aged 50-65.

What are the symptoms of ulcerative colitis?

Symptoms can localize to the intestinal tract including diarrhoea, urgency to rush to the toilet, bleeding from the rectum, abdominal cramps and pain or be more generalized including weight loss and tiredness. Patients can also have manifestations outside the gastrointestinal tract including joint aches, rashes, abnormal liver tests and red eyes.

How is ulcerative colitis diagnosed?

Ulcerative colitis is a chronic condition and acute infection, usually with a stool test, needs to be excluded. The definitive diagnosis is with examination of the colon via a colonoscopy with biopsies.

How is ulcerative colitis treated?

The aim of treatment with ulcerative colitis is to return the patient to their normal function and heal the bowel. There are many treatment options including orally and rectally delivered medications localized to the bowel or medications which down regulate the overactive immune system. These can involve injections or infusions in more moderate to severe cases. In rare life threatening cases patients may need surgery to remove their colon.

What lifestyle changes are helpful?

There is no specific diet for ulcerative colitis but it is ideal to avoid processed foods and include adequate fibre including fresh fruit and vegetable. Good fats including olive oil, avocado and fish may be beneficial. There is some evidence to suggest adequate sleep and exercise may decrease the risk of flares.

Is there a risk of cancer?

If the ulcerative colitis is not controlled adequately then over a long period of time there is a theoretical risk of bowel cancer. Patients with UC should be monitored for this based upon their risk.

Is there a cure for ulcerative colitis?

There is no current cure for ulcerative colitis. There is much research into the cause and treatments which has revolutionized the management of this condition. With optimal care a patient’s symptoms can be minimised and complications avoided.