Ulcerative colitis

Ulcerative colitis is a type of inflammatory bowel disease that causes chronic inflammation of the lining of the colon and the rectum. Unlike Crohn’s disease, it affects only the colon and the rectum. When you have ulcerative colitis, your immune system mistakes food, the normal bacteria that inhabit the colon, and other material in the colon, for foreign substances that it should attack. The abormal immune response sends white blood cells to the lining of the large intestine. The white blood cells cause chronic inflammation and ulceration. Ulcerative colitis starts in the rectum and can extend upward into the colon, like fire up the wall. The extent of your colitis is important to understand because it can treatment and how often you will be monitored with a colonoscopy.

Symptoms of Ulcerative colitis

Normally, the large intestine absorbs water from stool so it changes from a liquidy substance to something more solid. When you have ulcerative colitis, inflammation damages the lining of the colon. That damage prevents water from being absorbed, so your stool becomes watery. Ulcerative colitis can also cause the large intestine to bleed and produce pus. The symptoms of ulcerative colitis usually begin gradually and then get worse over several weeks. The severity of the symptoms can range from mild to severe. Symptoms can flare up and then disappear for months, even for years. When symptoms aren’t present, they are said to be in remission. Symptoms are very likely to return if the disease is not treated properly. Every patient  is different, but here are some of the common symptoms of ulcerative colitis:

  • Bloody diarrhea
  • Mucus in the stool
  • Frequent bowel movements (from 3 to 4 times a day to as many as 20)
  • Urgent bowel movements (the urge to go comes on very suddenly)
  • Abdominal pain
  • Tenesmus
  • Fever, fatigue, or both
  • Weight loss

Different types of Ulcerative colitis

Ulcerative colitis may affect just a small part of the colon or rectum, a larger part, or the entire colon. Knowing the extent and location of the disease may affect how the condition is treated.

Different types of ulcerative colitis are named for the part of the colon that is affected.

  • Proctitis: Rectum only
  • Proctosigmoiditis: Rectum and the sigmoid colon
  • Left-sided ulcerative colitis: The left side of the colon, up to the splenic flexure
  • Extensive ulcerative colitis: The left side of the colon and the transverse colon up to the hepatic flexure
  • Pancolitis: The entire colon
  • Backwash ileitis: Severe pancolitis that also affects the ileum, the last part of the small intestine.

How do you diagnose Ulcerative colitis

A general medical history will be needed, assessing your symptoms and how they started. Additionally, blood tests looking for infection (white blood counts) and anemia can aide in the diagnosis.  Stool tests are often used to rule out other  causes of diarrhea.

The IBD7 test, used to identify antibodies, is doubtful in its ability to diagnose colitis. More often, a colonscopy is needed to make a definitive diagnosis where biopsies can show whether the intestinal wall is inflamed in a way that is consistent with ulcerative colitis.

To rule out Crohn’s disease, a CT scan of your abdomen or pelvis may be needed. This scan allows your medical team to see any inflammation in the small intestine or fistulas, which are indicative of Crohn’s rather than Ulcerative colitis.