Dr. M.J. Bazos, MD.
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
Living With Your
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
goal of treatment is to relieve the symptoms, control the inflammation, and
prevent complications. Anti-inflammatory drugs are the main
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.
• Maintain normal physical
activity except when symptoms require bed
• Take medications as
• A heating pad or hot
water bottle placed on the abdomen may help with pain and
• See your physician
regularly. Evaluation of the bowel by colonoscopy to monitor for cancerous
changes is important.
• 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
• Avoid spicy foods, coffee,
and alcohol. They can cause diarrhea symptoms to
When to Call Your
• If you have symptoms of
• If fever or chills
• If the number of bowel
movements increase or if bleeding
• If the abdomen becomes
distended, the pain increases, or vomiting