Ulcerative Colitis

Ulcerative colitis is the inflammation of the colon and large intestine and results in sores and ulcers in their lining. It is a type of inflammatory bowel disease(IBD) that tends to affect the innermost lining of your large intestine. Symptoms of this condition are usually gradual and develop over time. Ulcerative colitis(UC) is a severely debilitating condition and may prove to be hazardous in the long run. It has been estimated that in India the incidence of Ulcerative colitis is quite high and affects around 12 lakh people annually. UC has no proper cure but can be managed greatly with lifestyle modifications and proper management. Some of the common symptoms, treatment and causes of UC are


Symptoms of ulcerative colitis

Symptoms of ulcerative colitis vary depending upon the severity of inflammation. However, some of the common symptoms of ulcerative colitis are
• Abdominal pain and cramps
• Diarrhoea
• Defecation urgency
• Rectal pain
• Fatigue
• Weight loss
• Fever

Types of ulcerative colitis

The type of ulcerative colitis is defined as per its location. Following are the types of ulcerative colitis are
Ulcerative proctitis
In this type of ulcerative colitis, the inflammation is bound to the area close to the rectum and is marked by rectal bleeding.
Inflammation is confined to the rectum and sigmoid colon and is marked by abdominal cramps and bloody diarrhea.
Left-sided colitis
Inflammation is not just confined to the rectum and sigmoid colon but extends to descending colon.
Pancolitis affects the entire colon and is marked by bloody diarrhoea that is quite severe and is accompanied by abdominal pain, fatigue, pain and weight loss.
Acute severe ulcerative colitis
It is a rare form of ulcerative colitis accompanied with profuse diarrhoea, bleeding, inability to eat and affects entire colon and rectum.

Causes and risk factors

The exact cause of colitis remains to be unknown, however, hereditary is known to play a major role in the occurrence of ulcerative colitis. Some of the risk factors that could contribute to ulcerative colitis are
• Age
• Family history
• Race and ethnicity

Diagnosis of ulcerative colitis

Blood tests
Blood tests can figure out any underlying signs of infection and anaemia.
Flexible Sigmoidoscopy
In this diagnostic measure, a thin and flexible lighted tube is used for examining sigmoid and rectum. This test is quite useful for a severely inflamed colon.
In case of severe symptoms an X-ray could be done to find out the complications such as the perforated colon
CT scan
A CT scan can give you the idea of how much of the colon and rectum are inflamed.

Treatment of ulcerative colitis

Though ulcerative colitis is not completely curable however with the help of certain medications and surgery, it can be managed. However, it is important to weigh the risks and benefits associated with the use of these medications. Following are the treatment options for the management of ulcerative colitis

Anti-inflammatory drugs

These often form the first line treatment of ulcerative colitis. Some of the common anti-inflammatory medications used are

5-amino salicylates

These medications are taken either by mouth or as an enema depending upon the affected area of the colon. Some examples of 5-aminosalicylates are Sulfasalazine and Mesalamine.


These type of medications are employed for moderate to severe ulcerative colitis and includes medicines like Prednisone and Hydrocortisone.


Immunosuppressants help in controlling the inflammation by suppressing one’s own immune system. Some of the commonly used immunosuppressants are

Azathioprine and Mercaptopurine

These are amongst the commonly prescribed immunosuppressants for people suffering from this condition.


Cyclosporine is for the short-term use for people who do not respond well to other medications. Infliximab, Adalimumab and Golimumab
These medications, also known as tumor necrotic factor(TNF) inhibitors, function by neutralizing a protein responsible for our immunity. These medications are for people who are suffering from severe ulcerative colitis and have stopped showing any response to other medications.


For controlling the infection associated with ulcerative colitis, the doctor may prescribe the course of antibiotics.


For pain, which is mild in nature your doctor might recommend. However certain analgesics such as ibuprofen and diclofenac should be strictly avoided if one is suffering from ulcerative colitis.

Iron supplements

In case of chronic intestinal bleeding, you may suffer from anaemia and may require iron supplements.


Surgery is often the last resort for ulcerative colitis where the colon and rectum are removed for avoiding any further complications. This involves a procedure called ileal pouch and anal anastomosis,in this procedure the surgeon builds a pouch from your intestine to the opening of the anal canal so that you can defecate normally.

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