Ulcerative Colitis Symptoms, Treatment, & Medication

Sep 6, 2019 | General Medical, IBD

When there’s a problem in your gut, it can feel all-encompassing and deeply uncomfortable. Diarrhea, bloating, nausea…the terms themselves conjure images of a person doubled over in discomfort, wishing it could feel better. The list of symptoms can be extensive, but it all leads to the same conclusion: something is wrong in your bowels. 

The effect can seem and feel much worse when it has become an ongoing thing. Perhaps regular diarrhea or bloating. Perhaps you’ve tried making adjustments to your diet. Perhaps you’ve tried numerous over the counter medications to try to bring relief. But sooner or later, it comes back. 

If you have this kind of ongoing problem in your bowels, it’s possible you are experiencing the symptoms of ulcerative colitis, one of several digestive diseases that may very well explain your seemingly endless gastrointestinal discomfort.  

What is Ulcerative Colitis?

Ulcerative colitis is essentially a type of inflammatory bowel disease (sometimes referred to as an IBD). The term inflammatory bowel disease generally refers to one of several chronic diseases that affect the gastrointestinal tract, the system of organs from the mouth to the anus that is responsible for ingesting food, extracting nutrients, and disposing of waste materials. 

Ulcerative colitis is one of the more common IBDs, but microscopic colitis and Crohn’s disease are also fairly common examples in the category (they are completely unrelated to a similar-sounding condition—irritable bowel syndrome). They all share some common symptoms, but they each have specific characteristics that set them apart. 

Ulcerative colitis is focused on and limited to the large intestine—also known as the colon. The key characteristics that set it apart from Crohn’s disease is the irritation, swelling, and sores on the inner lining of the colon. Crohn’s disease, by comparison, can affect other parts of the gastrointestinal tract such as the small intestine, and it can be limited to certain areas. Ulcerative colitis is a more broad inflammation of the inner lining of the entire colon. 

One of the other main characteristics of ulcerative colitis is that it is chronic. When doctors refer to a condition as ‘chronic,’ they are referring to something that is long-lasting or persistent. For many sufferers of ulcerative colitis (and IBDs in general), the symptoms tend to recur, and there is currently no known cure. The best hope is a long term remission. 

What Are the Symptoms of Ulcerative Colitis?

This disease tends to occur in people who are between 15-30 years old or over 60 years old. It typically begins with mild symptoms but those symptoms can increase in severity over time. Many people who suffer from the disease will have periods of mild symptoms, severe symptoms, and even periods of remission; the remission can be weeks or months without any symptoms at all. 

The symptoms can vary from patient to patient and can be similar to symptoms of other IBDs or other milder gastrointestinal afflictions. But typically a patient will be experiencing one or more of the following: 

  • Frequent diarrhea/loose bowel movements 
  • Rectal bleeding or bloody diarrhea 
  • Weight loss due to diarrhea-related lower water weight 
  • Rectal tenesmus – the sensation of having an incomplete bowel movement
  • Abdominal pain or cramping 
  • Incontinence – the loss of bowel control 
  • Feeling lethargic 
  • Loss of appetite 
  • Fever 

Ulcerative colitis can sometimes be connected to problems with the body’s immune system as well. In those cases, there are some additional symptoms that may present due to various organs’ weakened state: 

  • Joint pain
  • Lower back pain
  • Neck pain 
  • Rashes on the skin 
  • Eye soreness or irritation 
  • Vision difficulty

What is the Cause of Ulcerative Colitis?

Unfortunately, doctors and scientists are still unsure about the precise causes of this condition. Some research has shown, however, that there may be genetic or environmental factors that play a role in its development. It also may possibly derive from individuals with overactive intestinal immune systems. 

A normally functioning immune system guards against infection by seeking out and destroying potentially harmful foreign agents in the body – typically in the form of viruses or bacteria. Recent research has uncovered evidence that an overactive immune system – when triggered by the presence of a harmful substance in the body – can attack the lining of the colon. Such an attack could possibly create the very inflammation that leads to the chronic symptoms seen in ulcerative colitis. 

Many researchers and doctors also believe that the tendency to develop ulcerative colitis and other IBDs may be passed on genetically. Some recent studies have identified some genes that seem to be present in people with these gastrointestinal conditions. At present, it is still just a theory, however. 

The other category of potential causes is environmental factors. Like the other possibilities scientists have been exploring, there isn’t enough research to say definitively, but some studies have shown apparent patterns related to diet and some medications. A few of the medications that might have an impact are oral contraceptives, antibiotics, and NSAIDs (nonsteroidal anti-inflammatory drugs).

How is Ulcerative Colitis Diagnosed and Treated? 

If you have been noticing a persistent change in your bowel habits or bowel movements – or if you have been experiencing any of the symptoms above – you should make an appointment to see a gastrointestinal specialist. As with many other conditions you would seek medical advice for, the doctor will look at your family history as well as perform a physical exam. 

Depending on your symptoms, the doctor may also order a blood test or take a stool sample in order to rule out other conditions. These tests are often useful for determining if there is an infection that might be causing the symptoms. 

The other diagnosis methods the doctor may use are a colonoscopy or sigmoidoscopy – types of endoscopy that are used to examine the inside of the large intestine. The colonoscopy involves a long, flexible tube with a camera on the end; this flexible tube is inserted into the rectum and up into the colon to observe the condition of the inner lining. The presence of sores or ulcers will signal that it is indeed ulcerative colitis. 

The colonoscopy also allows the gastroenterologist to determine the severity of the inflammation of the colon’s lining, which will, in turn, inform the time of treatment he or she prescribes. If the doctor determines that it is ulcerative colitis, the two primary options are medication and surgery. 

While no medical cure for the disease currently exists, medications can potentially significantly increase a patient’s quality of life by lessening the severity of the symptoms or even promoting longer periods of remission. Some of the medications a doctor might prescribe are mesalamine, sulfasalazine, aminosalicylates, immunomodulators, corticosteroids, or biologics (anti-TNF therapies). Some of the potential side effects of these medications include mood swings, weight gain, acne, or high blood pressure. Some also might require being administered by enema or suppository.  

For cases of severe ulcerative colitis – or those who may have a higher risk of colon cancer – surgery may be considered. These options are rarely required for the majority of patients. If necessary, the surgeon will remove the entire colon; this procedure then requires either an internal (ileoanal reservoir) or external (ileostomy) collection pouch.  

Beyond medication and surgery, diet can play an important role in treatment. While research doesn’t show a link between diet and the cause of the disease, it is nevertheless an important factor in living with the condition. Simple things, like drinking plenty of liquids and eating less fiber when symptomatic, can be beneficial to the other treatment options the doctor prescribes. 

Ulcerative Colitis Appointment

If you suffer from this chronic condition, it can be a huge burden on your daily life; dealing with the ongoing symptoms is unpleasant and uncomfortable. There may be another explanation for your symptoms, though, so it is important to be mindful of your bowel habits and be aware of any changes that occur over time. It is also very important to follow all of your doctor’s orders and Achilles appointments.

If you think you may have ulcerative colitis or have been experiencing some of the symptoms discussed here, particularly if they have been persistent, contact the Gastroenterology Consultants of Savannah to make an appointment. We have several convenient locations and a helpful staff that is dedicated to providing excellent healthcare.