Ulcerative Colitis

What is Ulcerative Colitis?

Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) affecting the large intestine, mainly the rectum and colon. The disease is marked by inflammation and ulceration of the innermost lining of the intestine, called the mucosa. Ulcerative colitis usually develops first in the rectum but the inflammation most often extends continuously from there into the colon. Ulcerative colitis is a chronic disease, which means that it is on-going and once someone has been diagnosed with UC it means that they will probably always have UC. However, UC generally follows a pattern of active flare or flare-up (periods of active inflammation that causes noticeable symptoms) followed by periods of remission (inflammation has subsided and there are no obvious symptoms).

What are the signs and symptoms of Ulcerative Colitis?

Not everyone diagnosed with UC will have the same symptoms or be affected in the same way, but the most common symptoms reported by ulcerative colitis patients include: frequent bowel movements, occasionally uncontrollable diarrhoea, urgency for bowel movements, rectal bleeding, cramping or abdominal pain, bloating, fatigue, weight loss, and sometimes anaemia.

What are the causes of Ulcerative Colitis?

Exactly what causes UC is unknown. Research suggests that there are a number of factors that may combine together to cause some people to get UC and not others. Some of the factors that have been studied include inherited factors (that is, genetic make-up or family history) and environmental factors (for example, where someone lives or comes from, diet, stress, or smoking habits). It is also thought that UC may result because the immune system is not working properly. However, researchers have yet to find out for sure and this is why treatment is aimed at controlling symptoms rather than identifying and removing the cause.

Who is likely to be at risk of Ulcerative Colitis?

UC affects men and women but who gets UC and who does not probably depends on a combination of factors playing a role—whether there’s a family history of UC or a similar condition or whether their immune system is not working properly. Research has shown that ulcerative colitis can run in families. For this reason, some researchers are looking to see whether the presence of specific genes puts a person at greater risk for developing UC, whilst other researchers are looking into how the immune system works in those with UC compared to those without UC.

How is Ulcerative Colitis diagnosed?

There is no single test which can establish the presence of ulcerative colitis. A diagnosis is usually made through a combination of tests and examinations including blood and stool sample tests, physical and rectal examinations, colonoscopy/sigmoidoscopy (a procedure where a camera is passed into the colon) and biopsy (taking a sample of the inner lining of the colon).

What are the treatments for Ulcerative Colitis?

The aim of treatment in UC is to reduce inflammation and to keep it under control so that it does not cause symptoms (remission). For those with active UC (flare), treatments are given to induce remission and once in remission treatment is continued to make sure those with UC remain in remission and symptom free (this is called maintenance therapy). Several groups of medicines may be used to treat ulcerative colitis and these include aminosalicylates (5-ASAs), corticosteroids, immunomodulators and biological therapies.