Dr. M.J. Bazos, MD. Patient Handout


About Your Diagnosis

Ulcerative colitis (UC) is a chronic inflammatory disease of the colon. Granulomatous colitis is another name for this disease. It is one of two disorders listed under the category of inflammatory bowel disease. The other disorder is Crohn’s disease. Ulcerative colitis causes tiny ulcers and small abscesses to form in the inner lining of the colon. The cause of UC is not known. It affects men and women equally and appears to run in some families. About 250,000 Americans have UC. The most commonly affected individuals are between the ages of 15 and 35 years. Detection of UC is by a flexible sigmoidoscopy, a procedure where a lighted flexible instrument is inserted into the rectum to view the rectum and the lower portion of colon. Tissue samples are taken from the colon and sent for microscopic examination. Alternative detection methods are colonoscopy, a procedure similar to a flexible sigmoidoscopy but with a longer instrument, or barium enema x-ray. Ulcerative colitis is a lifelong condition in most individuals. About half of the patients will have only mild symptoms. Others experience more frequent and severe attacks. Medications can control the symptoms. This condition is sometimes curable with surgery.

Living With Your Diagnosis
Abdominal pain and bloody diarrhea with mucus are the most common symptoms of UC. The abdominal pain is usually on the left side. A bowel movement may help relieve the pain. As the condition worsens, the diarrhea increases in frequency, Up to 20 stools a day is common. Symptoms of UC may alternate with periods of remission. Over 75% of patients will have relapses. Other symptoms include fatigue, weight loss, loss of appetite, and fever. Symptoms are not limited to the colon. About 15% to 20% of individuals will have joint pains. The most commonly affected joints are the knees, ankles, and wrists. Eye problems occur in up to 10% of individuals. Complications of UC include severe hemorrhage (blood loss), perforation of the bowel, megacolon (dilatation of the colon), and peritonitis (infection of the abdomen). Individuals with UC are at greater risk for having colon cancer.

The goal of treatment is to relieve the symptoms, control the inflammation, and prevent complications. Anti-inflammatory drugs are the main medications
used; these include sulfasalazine, mesalamine, olzalazine, and corticosteroids. Sulfasalazine is used to maintain remissions and control minor-to-moderate symptom flares. Corticosteroids are used for major flares and to maintain remissions. This drug can be given as an enema if needed. If symptoms are severe, hospitalization is necessary. The bowel is put at rest (no food orally) and intravenous nutrition given. About 20% to 25% of UC patients require surgery at some time. Patients who do not respond to medications or have severe disease are good candidates for surgery. The surgery involves removing the affected portion of the colon and joining the two ends of bowel.

The DOs
• Maintain normal physical activity except when symptoms require bed rest.
• Take medications as prescribed.
• A heating pad or hot water bottle placed on the abdomen may help with pain and cramping.
• See your physician regularly. Evaluation of the bowel by colonoscopy to monitor for cancerous changes is important.

The DON’Ts
• Avoid aspirin. This medication can cause bleeding.
• Avoid antidiarrheal medications except for minimal symptoms. These medications can cause megacolon.
• Avoid raw fruits and vegetables. They can cause the symptoms to worsen.
• Avoid spicy foods, coffee, and alcohol. They can cause diarrhea symptoms to worsen.

When to Call Your Doctor
• If you have symptoms of UC.
• If fever or chills develop.
• If the number of bowel movements increase or if bleeding increased.
• If the abdomen becomes distended, the pain increases, or vomiting starts.