Articles

Ulcerative Colitis

For the third time in recent months a friend or family member told me that they have a family member who has ulcerative colitis. Although I did not think this disease was very common, it is estimated about a million Americans are living with ulcerative colitis, making it the most common form of inflammatory bowel disease. Ulcerative colitis is an inflammatory bowel disease that causes inflammation and ulcers (sores) in the digestive tract. It affects the innermost lining of the large intestine (colon) and rectum. The exact cause of this disease is not known. It was previously thought diet and stress caused the disease, but although these may aggravate the disease, researchers now believe it is the result of an overactive immune system that mistakenly attacks your body, which causes inflammation and tissue damage. It is also thought heredity may play a part in the disease.

Ulcerative colitis affects both men and women equally but risk factors include age (often between 15- 30 years of age or over 60), race (Ashkenazi Jewish), eating a high-fat diet, having a close relative with the disease, and use of nonsteroidal anti-inflammatory drugs, like Advil or Motrin.

Early symptoms may include diarrhea, abdominal cramping, tiredness, nausea, weight loss, and anemia. As the disease progresses, blood or mucus in bowel movements, cramping, fever, skin rashes, mouth sores, joint pain, red, painful eyes, liver involvement, and loss of nutrients may occur.

Other bowel diseases that may mimic the same symptoms as ulcerative colitis (which only affects the large intestines) includes Crohn’s disease, which affects other places in the digestive tract, or irritable bowel syndrome, which is a problem with the muscles in the bowels, not inflammation.

Diagnosis of ulcerative colitis is made after testing and exams. It is important to consult your doctor if you feel you might have this condition. Blood tests will be done to determine if you are anemic or have an infection. Your stool will be checked for signs of infection. Imaging tests and a colonoscopy or sigmoidoscopy will be performed to visualize the colon and you will most likely be referred to a gastroenterologist (digestive system specialist).

There is no cure for ulcerative colitis, but treatments can calm the inflammation. Treatment depends on the severity of the disease and the person. Usually the disease is managed by diet and medications with the goal being remission of the disease. When medications are not working or complications such as bleeding and abnormal growths are present, surgery may be needed. About 30% of people with ulcerative colitis need surgery during their lifetime, according to researchers with about 20% of children needing surgery.

Nutrition is important if you have ulcerative colitis to avoid flare-ups. Trigger foods may be different from person to person so it is important to keep track of foods that upset your stomach after eating. Foods and drinks high in sugar or fat, carbonated beverages, high fiber foods, alcohol, salt, and dairy products may be problematic. No one diet works best for ulcerative colitis and supplemental nutrition and vitamins may be necessary.  For children, it is important to ensure they are getting the nutrients they need to grow and maintain health. It is important to consult with a healthcare provider and dietician to develop a personalized diet.

For most people, ulcerative colitis is a chronic condition with periods of flare-ups and periods with no symptoms. Some people have very few flare-ups while other have many. That is why it is important for people with this disease to try and manage it with their prescribed treatment plan to avoid complications.

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