Ulcerative colitis is a condition which causes the colon (or large intestine) to become inflamed, often resulting in ulceration and bleeding. The colon or large intestine is the last part of the digestive system, and it extracts nutrients from undigested food before it is eliminated from the body.
According to Colitis UK, the disease affects around 120,000 people in the UK. The condition normally first appears between the ages of 15-30.
Conditions such as ulcerative colitis or Crohn's disease that cause inflammation of the intestines are known as inflammatory bowel disease (IBD).
The symptoms of ulcerative colitis will vary depending on how much of the colon is affected, and also depending on the level of inflammation. Symptoms can vary from mild (where the condition is a minor inconvenience) to severe cases (where the quality of life is severely affected). In severe cases, ulcers can form on the lining of the colon, and these can bleed and produce mucus.
Common symptoms include abdominal pain and bloody diarrhoea. There can also be a frequent need to go to the toilet, weight loss, loss of appetite, tiredness, fever, dehydration and anaemia. Symptoms are often worse first thing in the morning, and ulcerative colitis can be unpredictable, flaring up and then go into remission, with very few symptoms, for a period of months. It is not clear what causes the return of the symptoms, but stress is thought to be a trigger.
The exact causes of ulcerative colitis are not known. Research suggests that genetic and environmental factors both play a part. In terms of genetics, studies have shown that 20% of people with ulcerative colitis, also have a close relative who suffers from the disease. The prevalence of the condition is also higher in certain ethnic groups. Scientists have also recently identified a mutated gene that they believe may be linked to the disease.
Ulcerative colitis is also associated with a malfunction of the immune system, where the body’s own cells attack the lining of the colon, causing inflammation. The body then takes this inflammation as a sign of further infection, so increasing the immune response in a vicious cycle. Some researchers believe that a viral or bacterial infection may be the trigger to cause the body’s cells to attack the colon lining. Others believe that it is just a malfunction of the immune system, fighting an infection when no infection is actually present.
Once ulcerative colitis has been diagnosed, you will usually be referred to a gastroenterologist who will assess the severity of your condition. The severity of the ulcerative colitis is judged by how many times you are passing stools, whether those stools are bloody, whether you have symptoms of fever, how much control you have over your bladder, and your general wellbeing.
Although there is no cure for ulcerative colitis, there are a number of successful treatments which can relieve the symptoms. A variety of medications can be used to either reduce the inflammation (such as steroids or amniosalicylates), or to reduce the immune system response (immunosuppressants). In severe cases of ulcerative colitis, hospitalisation or surgery may be required, because severe colitis could put you at risk of dehydration, malnutrition and potentially fatal complications such as the colon rupturing.