Ulcerative Colitis

What is ulcerative colitis?
Ulcerative colitis is a chronic condition that causes inflammation and ulcers in the lining of your colon, or large intestine. It may affect the whole colon or just a portion of it.

Ulcerative colitis is one of the two main inflammatory bowel diseases of the gastrointestinal tract. The other is called Crohn’s disease.

What are the symptoms of ulcerative colitis?
Symptoms will vary for individuals, but typically you will feel:
  • Abdominal pain
  • Diarrhea
  • Fever
  • Unexplained weight loss
  • Loss of appetite
  • Rectal bleeding
  • Anemia
  • Mucous in stools
Many people will only suffer from mild to moderate symptoms, while a small portion will experience severe symptoms. The severity of your symptoms typically depends on how much of your colon is affected. If your entire colon is affected, then you will feel more symptoms compared to having only a portion of your colon affected.

What causes ulcerative colitis?
Ulcerative colitis can develop at any age, but is more common seen amongst those aged 15-30. Men and women have an equal chance of developing ulcerative colitis. Those who have a family history of inflammatory bowel diseases or other gastrointestinal problems have an increased risk of ulcerative colitis. Caucasians and people of Jewish descent also have increased risk.

Who develops ulcerative colitis?
Ulcerative colitis can be developed at any age, but is more common amongst those aged 15-30. Men and women have an equal chance of developing ulcerative colitis. Those who have a family history of inflammatory bowel diseases or other gastrointestinal problems have an increased risk of ulcerative colitis. Caucasians and people of Jewish descent also have increased risk.

How is ulcerative colitis diagnosed?
Ulcerative colitis is difficult to diagnose because of similarities in symptoms that are present in other digestive disorders such as irritable bowel disease and Crohn’s disease. Both ulcerative colitis and Crohn’s disease are classified as inflammatory bowel diseases, but they are different in their characteristics. Ulcerative colitis causes only shallow inflammation which is confined only to the large intestine, whereas Crohn's disease causes inflammation deeper within the intestinal wall and can occur in other parts of the digestive system as well, including the small intestine, mouth, esophagus, and stomach. The tests Dr. Khorrami may use to diagnose ulcerative colitis include:
    Blood tests
    These can be used to look for anemia caused by bleeding. Blood tests may also uncover a high white blood cell count, which is a sign of inflammation or infection somewhere in the body.

    Stool tests
    These are commonly done to rule out other causes of GI diseases, such as infection. Stool tests can also show if there is bleeding in the intestines.

    Sigmoidoscopy and colonoscopy
    These tests are used to help diagnose ulcerative colitis and determine how much of your digestive tract is affected. Colonoscopy is the most commonly used test to specifically diagnose ulcerative colitis. Colonoscopy is used to view the ileum, rectum, and the entire colon, while sigmoidoscopy is used to view just the lower colon and rectum.

    A procedure that involves taking a small tissue sample of intestinal lining for examination with a microscope. The process is painless and you will not feel the biopsy.

    Computerized tomography (CT) scan
    CT scans use a combination of x rays and computer technology to create three-dimensional (3-D) images of the human body. For a CT scan, the person may be given a solution to drink and be injected with a special dye, called contrast medium. CT scans require the person to lie on a table that slides into a tunnel-shaped device where the x rays are taken. CT scans can be used to help diagnose ulcerative colitis.
How is ulcerative colitis treated?
Treatment varies from individual to individual and depends on factors such as severity of symptoms and prior response to medications.

Prescription Medication
No medication can cure ulcerative colitis, but its symptoms can be successfully treated with a variety of medications including aminosalicylates, corticosteroids, immunomodulators, and antibody injections. Some of these medications are prescribed in combination for maximum relief. Dr. Khorrami will monitor your response to prescribed medications to determine which option works best for you. Other medications may be prescribed to decrease emotional stress or to relieve pain, reduce diarrhea, or prevent infection.

Those who suffer from ulcerative colitis may eventually be required to have surgery. Roughly 10 – 40% of those diagnosed undergo surgery to remove either the whole colon, or only a portion of it. Surgery is recommended if precancerous or cancerous changes are seen in the colon biopsies, or if medication treatment and lifestyle changes have been unsuccessful in controlling symptoms.

The type of surgery recommended will be based on the severity of the disease and the person’s needs, expectations, and lifestyle. People faced with this decision should get as much information as possible by talking to their doctors and any specialists that can provide information.

Eating, Diet, and Nutrition
Improving your diet has the potential to reduce your symptoms. Here are general tips that you should follow:
  • Eat 5-6 smaller meals instead of 3 large ones.
  • Avoid carbonated drinks.
  • Eat bland foods such as rice, baked potatoes, fruits, vegetables, eggs, soup, bread, crackers, and oatmeal.
  • Avoid high-fiber foods such as corn and nuts.
Should I be worried about colon cancer?
People with ulcerative colitis have an increased risk of colon cancer when the entire colon is affected for a long period of time. Effective maintenance of remission by treatment of ulcerative colitis may reduce the risk of colon cancer. Surgical removal of the colon completely eliminates the risk of colon cancer. A colonoscopy can prevent colon cancer by detecting any signs of cancerous polyps, which are then removed immediately on site.

Discuss Your Options with Dr. Khorrami
Dr. Khorrami has been in practice since 1996 as a double-board certified gastroenterologist, has experienced a variety of patient cases, and is well trained to solve your digestive problems. Get in touch to learn about ulcerative colitis and how you can successfully treat it.

Source contains material from the National Digestive Diseases Information Clearinghouse (NDDIC).


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About Dr. Khorrami

Dr. Payman Khorrami is a UCLA graduate, has been in practice since 1996, and is double board certified. Undergraduate Education at University of California, Berkeley, Medical School at University of California, San Francisco, Internal Medicine Training at University of California, San Diego Read Full Bio