Ulcerative Colitis: Symptoms, Diagnosis, Risks & Treatment

According to a study by Rupa Banerjee et al. in 2023, ulcerative colitis contributed to 2.2% of all inflammatory bowel disease cases. These findings show the significant healthcare burden associated with the condition. But how do you know if you are suffering from it? 

Ulcerative colitis symptomsmay not be noticeable initially and become problematic later. Persistent changes in your digestive health or bowel habits may indicate worsening issues. Learn about the symptoms, diagnosis, treatment, and more.

Colitis is the inflammatory response in the colon (large intestine). It is the final portion of the gastrointestinal tract, and the rectum is found just below it. The swelling in this lining causes abdominal pain, cramps, bloating, and blood in the stool. 

In ulcerative colitis (UC), the chronic response in the body progresses to the formation of sores or ulcers. It can cause frequent bowel movements and sometimes mucus or pus discharge.

Doctors classify UC based on the affected area. Typically, the inflammation starts in the rectum, closest to the anus, and may spread further along the colon. 

Ulcerative colitis symptoms can gradually worsen over time. The following are the signs and symptoms of people with inflammatory colitis:

Early Signs (Mild):

1. Diarrhoea (with or without blood)

2. Increased bowel movements and tenesmus (urge to defecate but no stool discharge) (up to 4 times a day)

3. Mild cramping or abdominal discomfort

Later Signs (Moderate to Severe):

1. Frequent bowel movements (4 or more times a day)

2. Blood, mucus, or pus in stool

3. Severe cramping

4. Extreme tiredness (fatigue)

5. Unexpected weight loss

6. Nausea

7. Fever

The actual cause of ulcerative colitis is still unknown. However, it can be triggered by various risk factors. It can be classified as controllable and uncontrollable factors. 

Uncontrollable Aspects:

1. Age: Generally diagnosed between 15 and 35 years old, with a secondary peak in those between 50 and 75.

2. Family History: Having a close relative (parent, sibling, child) with colitis significantly raises your risk.

3. Immune System Dysfunction: In UC, the defensive mechanism of the body seems to malfunction. It mistakenly identifies harmless substances in the gut as threats, leading to chronic inflammation.

Controllable Aspects:

1. Diet: High intake of polyunsaturated fatty acids might contribute to digestive problems.

2. Lifestyle: A sedentary lifestyle can negatively impact your overall health, including gut health.

3. Appendectomy: In some cases, it was found that removing appendix lowers risk of ulcerative colitis but increases chances of Crohn's disease.

While there isn't a confirmed method to prevent ulcerative colitis, maintaining a balanced diet can help to manage its symptoms.

1. Keep the meal portions small.

2. Stay hydrated.

3. Identify specific triggers with a food journal.

4. Take vitamins and supplements if needed due to nutrient absorption issues.

5. Certain pain medications (NSAIDs) may worsen symptoms. Discuss alternatives with your doctor.

Note: This information is a general guideline and shouldn't replace consulting a healthcare professional.

Ulcerative colitis can mimic other bowel conditions. This makes ulcerative colitis diagnosis crucial for proper treatment. The common tests doctors might use to identify the condition include:

1. Blood Tests: These check for signs of anaemia (low RBC count) due to bleeding. Inflammation markers like C-reactive protein and erythrocyte sedimentation rate (ESR) are also checked. 

2. Stool Test: This analyses your stool sample to detect inflammatory markers, bacteria, and parasites to rule out other causes.

3. Flexible Sigmoidoscopy: A flexible, thin tube with a camera is inserted through the rectum. It is to examine the lower part of your colon (sigmoid colon) and part of the descending colon.

4. Colonoscopy: This uses a longer, lighted scope called a colonoscope inserted through the rectum. It is to examine the entire length of your colon.

5. Biopsy: A tiny tissue sample from the colon may be taken during an endoscopy. It is examined under a microscope to confirm inflamed and ulcerated mass.

How to prepare for the doctor's consultation?

A doctor's consultation is vital in managing ulcerative colitis. Below are the steps that would help you prepare for an informative discussion:

1. Prepare Medical History: Compile a list of all medicines you take, including prescriptions, OTC drugs, and supplements. 

2. Track Symptoms: Record details like frequency of bowel movements, presence of blood in stool, abdominal pain intensity, and any other discomfort you experience.

Ulcerative colitis treatment focuses on regulating the immune system. It helps manage the condition. It necessitates a multifaceted approach, which is as follows:

Non-Surgical Methods

These are available to manage the condition and can help to improve the quality of life.

1. Medications: This works to calm down inflammation in the colon. It helps the tissue to heal and reduces symptoms like diarrhoea, bleeding, and stomach pain. These also prevent future flare-ups, leading to longer periods of wellness. 

2. Dietary modifications: A bland, nutrient-rich diet promoting healing and symptom reduction is crucial. Doctors may recommend lactose restriction for those with intolerance and a focus on easily digestible foods.

Proctocolectomy

This surgery involves removal of a part or complete colon and rectum. It can be done with two approaches:

1. With Ileal Pouch: The surgeon creates a pouch, which is a section of the small intestine attached to the anus. Once healed, it acts as a new rectum, allowing normal bowel movements. 

2. With Ileostomy:  A small opening is made in the abdomen, and a bag (ileal stoma) is created outside the body to collect waste. 

Estimated Cost of Ulcerative Colitis 

The cost of treating ulcerative colitis ranges depends majorly on the technique used. If proctocolectomy is done with an ileal pouch, then the price ranges from ₹ 1,50,000 - ₹ 2,00,000. While ileostomy can be around ₹ 1,25,000 - ₹ 1,50,000.

Note: The figures mentioned above are approximations and can vary due to variables like chosen hospital, surgeon, etc. Contact HexaHealth for accurate information and price quotation.

Ulcerative colitis usually doesn't improve over time. If left untreated, symptoms can stay or get even worse. It could lead to the following health conditions:

1. Uncontrolled Inflammation: The swelling in the colon can worsen and spread, making it harder to manage the disease later.

2. Nutritional Issues: You may experience malnutrition due to trouble absorbing nutrients, leading to symptoms like:

1. Loss of appetite

2. Swollen belly

3. Fatigue

4. Unintentional weight loss

3. Anaemia: Blood loss from ulcers can cause anaemia, making you feel tired and weak.

4. Increased Risk of Infections: Dehydration and malnutrition can impair the immune system, making you more prone to infections.

5. Colon Cancer: A 2019 study concluded that the risk of colon cancer escalates over time for UC patients. The rates were 0.7%, 1.3%, and 2% after 1–9 years, 10–20 years, and 21–30 years, respectively.

There is no specific ulcerative colitis diet for anyone as the response can vary for every individual. Generally following food items might be helpful in this condition are: 

1. Omega-3-rich foods: These have anti-inflammatory properties and are potentially helpful during inflammatory colitis flares. Examples include:

   1. Fatty fish like salmon, mackerel, tuna

   2. Walnuts, flaxseeds, chia seeds

2. Probiotics: Example includes yoghurt with live and active cultures.

3. Stay Hydrated

4. Seek Nutritional Support: Consider this if diet restrictions prevent meeting nutritional needs.

Foods to Limit During Ulcerative Colitis

Keep a food intake journal to identify foods that worsen your symptoms. These are general guidelines.

1. Lactose: Milk, cheese, and yoghurt may trigger symptoms in some people. Consider lactose-free options if dairy is a problem.

2. Red & Processed Meats: Limit red and processed meats to help avoid worsening symptoms.

3. Alcohol: Beer, wine, and liquor may trigger flares for some.

4. Carbonated Drinks: Soda and fizzy drinks can irritate your digestive system and cause gas.

5. Sugar Alcohols: Found in sugar-free products like gum and candy, these can trigger symptoms. Be mindful of natural sugar alcohols in some fruits as well.

6. Insoluble Fibre: Raw veggies like broccoli, whole grains, nuts, and fruits with skin can worsen cramping, bowel movements, and gas.

7. Sugary Foods: Cakes, pastries, candy, and juices may trigger colitis.

8. High-Fat Foods: Limit full-fat dairy, coconut, and processed foods high in palm oil.

9. Spicy Foods: Hot peppers, chillies, and spicy sauces may trigger or worsen flares.

10. Gluten (for some): Wheat, rye, and barley can be problematic. Consider a gluten-free diet if you suspect gluten is a trigger.

Ulcerative colitis is a chronic IBD (inflammatory bowel disease) associated with inflammation in the inner lining of your large intestine. Effective measures can help manage and achieve long-term relief. Early detection and timely treatment are crucial to prevent complications. 

HexaHealth guides you about the causes and ulcerative colitis symptoms along with top-tier hospitals and experts. We offer 24*7 assistance and personalised guidance. So, contact HexaHealth and take charge of your gut health today!

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