Ulcerative Colitis

What Is It?

A number of infections and other conditions can result in irritation and inflammation of the rectum, but few of them cause lasting symptoms. Ulcerative colitis, however, is a lifelong condition that begins with rectal inflammation and can progress to involve much or all of the large intestine. Ulcerative colitis most often begins to cause symptoms between the ages of 15 and 40.

Research suggests that people who develop ulcerative colitis are born with a genetic code that leads them to develop inflammation in the colon. A breakdown in the intestine lining may trigger the illness. Normally, the lining of the intestines keeps native bowel bacteria carefully sealed within the digestive "pipeline," where it remains invisible to your immune cells and does not provoke a reaction. When the intestine's lining fails, bacteria that are usually harmless can activate your immune system. Ulcerative colitis is an autoimmune disease, meaning that the immune system attacks part of the body. In ulcerative colitis, cells from the immune system collect in the bowel wall, and the bowel is injured by this inflammation. Once the inflammation has begun, it can persist, whether or not the immune system has continued exposure to the native bowel bacteria.

Ulcerative colitis affects the inner lining of the rectum and adjoining colon, causing it to wear away in spots (leaving ulcers), to bleed or to ooze cloudy mucus or pus. A few other parts of the body seem to be affected by inflammation and can develop symptoms in ulcerative colitis, including the eyes, skin, liver, back and joints. One serious concern about ulcerative colitis is that it substantially increases the risk of colon cancer.

The disease is not contagious, even within families, so there is no worry of direct spread of the disease from one person to another.

Symptoms

The symptoms of ulcerative colitis vary. Some people with the disease have a burst of symptoms every few months, whereas others have symptoms either continuously or rarely.

Typical symptoms include:

• Cramping abdominal pain, especially in the lower abdomen
• Bloody diarrhea, often containing pus or mucus
• A feeling that you have little warning before you need to have a bowel movement
• The need to awaken from sleep to have bowel movements

Ulcerative colitis also may cause fever, fatigue, decreased appetite and weight loss.

Diagnosis

To confirm a diagnosis of ulcerative colitis, most patients will need to have either flexible sigmoidoscopy or colonoscopy. Both procedures involve the use of a small movable camera and a light to view the insides of your large intestine. During either procedure, biopsy samples may be clipped from the lining of the intestine so that the samples can be examined under a microscope for signs of inflammation.