Ulcerative Colitis: Symptoms and Treatment

Greta Pelegrin and Venessa Rouzeau

Here are tips for preventing and managing inflammatory bowel disease

Ulcerative colitis is also known as inflammatory bowel disease because it mainly affects the large intestine, colon and sometimes the rectum. In this chronic condition, the colon and rectum become inflamed and develop ulcers or sores. As a result, you may experience bleeding and diarrhea, which are characteristic of ulcerative colitis.

No one knows what causes ulcerative colitis. The immune system is involved, but it is not clear exactly how. Ulcerative colitis affects men and women equally. You can have ulcerative colitis at any age, but it often occurs between the ages of 15 and 30 years, or later in life, from the ages of 50 to 70 years.

It is more common in whites and those of Jewish descent. It is important to receive treatment for ulcerative colitis. If left untreated, it can increase the risk of more serious complications in the long run.

--Some complications of ulcerative colitis are:

--Colon cancer

--Inflammation in other parts of the body, such as the skin, eyes and joints

--Liver disease

--Osteoporosis, or weakened bones

--Toxic megacolon

How do I know if I have ulcerative colitis?

Your doctor will first check for the usual symptoms of ulcerative colitis, mainly bloody diarrhea, abdominal pain and fever. Following this, several tests can be performed to confirm that it is ulcerative colitis. These include:

--Colonoscopy or sigmoidoscopy (cameras are used to view inside the intestine, and biopsies can be performed)

--X-rays (barium enema, computerized tomography scan)

--Stool samples to check for bacteria (sign of infection) and white blood cells (sign of inflammation)

--Blood tests for anemia

--Sedimentation rate, an indicator of inflammation

Ulcerative Colitis Symptoms

The symptoms of ulcerative colitis can be embarrassing and uncomfortable, and they can have a negative impact on your social life. Certain foods and spices can trigger the symptoms, causing bouts of diarrhea in public places.

The symptoms will vary depending on how serious your condition is, but they are manageable. Symptoms will occur as flare-ups (worsening of inflammation) that can range from mild, with symptoms coming on gradually, to severe, in which a person can become very ill. Some people may have periods of remission in which symptoms go away for months and even years, but in most, the symptoms will eventually return.

Mild ulcerative colitis symptoms include rectal bleeding, rectal pain or urge for a bowel movement (with no success), bloody diarrhea (from a few occasional episodes to several times a day), abdominal cramps and pain (which usually disappear after a bowel movement), fever, pain that moves to the left side and unintended weight loss.

Severe symptoms include bloody diarrhea that becomes severe with abdominal cramps and pain, fatigue and significant weight loss, as well as severe pain, profuse diarrhea, dehydration and shock (rare).

You may also experience joint pain, mouth sores, nausea and vomiting, skin lumps or ulcers, or anemia.

Preventing Flare-Ups

The recurrence of symptoms can be reduced by making some dietary and lifestyle changes. Avoiding certain foods that can worsen diarrhea and gas symptoms is a good start. Try the process of elimination to find out which specific foods aggravate your symptoms. The key is to eat a well-balanced diet to prevent the malnourishment that can result from your intestines not being able to absorb nutrients as well. Eliminating dairy products will only help people who are lactose intolerant.

To help control symptoms:

--Try eating small meals more frequently

--Experiment with fiber - getting more fiber can sometimes help eliminate diarrhea, but may also aggravate your symptoms

--Do not eat "gassy" foods, such as beans, cabbage and broccoli

--Avoid greasy or fried foods - these can cause more gas and diarrhea because your body might not be able to completely absorb the fat

--Drink plenty of fluids to prevent dehydration

--Avoid or limit alcohol and caffeine consumption

--Consider taking multivitamins to replace lost vitamins and minerals

Treatment

When flare-ups occur, medical treatment is necessary to control the inflammation that is triggering your symptoms. In more severe cases, when there is massive bleeding, rupture of the colon, risk of cancer or your condition is not responding to medical therapy, you might need surgery. About 30 percent of people with ulcerative colitis will require surgery. This involves removing the colon and rectum, which cures the ulcerative colitis and eliminates the threat of cancer.

There are four types of drugs that are used to treat the inflammation from ulcerative colitis: aminosalicylates, corticosteroids (often referred to as "steroids"), immunomodulators and biologics.

Over-the-counter alternatives can help treat some of the milder symptoms. For diarrhea, Immodium or Metamucil can help, and acetaminophen can alleviate pain. Ibuprofen and naproxen can actually worsen the symptoms of ulcerative colitis, so these should not be taken for pain.

You might receive antibiotics if you have a fever and your doctor suspects an infection. Iron supplements can be used to prevent anemia. Some herbal supplements that might help include fish oils, probiotics and Boswellia. Aloe vera has not been proven to be effective for ulcerative colitis.

Note: This article was originally published on July 11, 2011 on PharmacyTimes.com. It has been edited and republished by U.S. News.