COLITIS, ULCERATIVE

(Granulomatous Colitis)

 Basic information

description

Ulcerative colitis (UC) is a chronic inflammatory disease of the colon (large intestine). The inflammation causes small sores or ulcers. It usually affects the rectum (the lower end of the colon), but may affect the entire colon. It can occur at any age and in both sexes. UC is an inflammatory bowel disease (IBD) as is Crohn's disease. The two disorders have similar symptoms.

FREQUENT SIGNS & SYMPTOMS

• Symptoms may be mild, moderate, or severe. They can come and go .
• Diarrhea. Blood and mucus may be present.
• Abdominal cramping, tenderness, or sounds (e.g., gurgling).
• Urgency to have a bowel movement.
• Later symptoms may include: appetite and weight loss, fever, and anemia (e.g., paleness and fatigue).

causes

Unknown. Genetic, infectious, immunologic, and environmental (e.g., smoking) factors may be involved.

risk increases with

Family history of ulcerative colitis.

PREVENTIVE MEASURES

No specific preventive measures.

expected outcomes

The course of the disease varies. Symptoms tend to come and go throughout life. Treatment can help. It is curable with surgery.

possible complications

• Toxic megacolon (a rare, severe inflammation which can be life-threatening).
• Profuse bleeding, bowel perforation, or liver disease.
• Inflammation of joints, eyes, and skin .
• Colon cancer. Risk is greater with ulcerative colitis.
• Impaired growth and sexual development in a child.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your symptoms. Medical tests may include stool and blood studies and x-ray of the colon (barium enema). A sigmoidoscopy or colonoscopy may be done. In these procedures, a thin tube with a lighted tip is used to view inside the colon and rectum and a small piece of tissue can be removed for biopsy.
• Treatment will depend on the severity and extent of the inflammation. Treatment steps may include drug therapy, surgery, and, sometimes, diet changes.
• Hospital care may be needed if bleeding or dehydration develops. Fluids may be given through a vein (IV).
• Surgery to remove part of or the entire colon may be needed. This is done for severe symptoms (such as bleeding), rupture of the colon, cancer risk, failure of other treatments, or side effects of steroid drugs. The options for surgery and stool elimination will be explained to you.
• It is recommended that patients who have had UC for 6 to 7 years should start having a colonoscopy every 1 to 2 years for cancer screening purposes.
• Counseling may help with emotional aspects of the disease or the surgery. Try to decrease the stress in your life. Stress can worsen symptoms.
• To learn more: Crohn's and Colitis Foundation of America, 386 Park Ave. South, 17th Floor, New York, NY 10016; (800) 932-2423; website: www.ccfa.org.

medications

• Antidiarrheal drugs may be prescribed for diarrhea.
• Drugs called 5-Aminosalicylates (5-ASA) are usually prescribed to help control inflammation.
• Cortisone drugs may be prescribed for more severe symptoms. They may be taken by mouth, injected, given through an enema, or as a suppository.
• Drugs called immunomodulators may be prescribed.
• Antibiotics will be prescribed for infection.
• Vitamin and mineral supplements (e.g., iron) may be prescribed.

activity

Bed rest may be needed during acute attacks. Resume normal activity as soon as symptoms improve.

diet

• Eat a healthy diet. Some foods aggravate symptoms in different people. Keep a food diary to learn which foods cause you symptoms so you can avoid them.
• Avoid milk products if you have a lactose intolerance.

 notify our office if

• You or a family member has symptoms of ulcerative colitis.
• After diagnosis and treatment, fever and chills develop, the frequency of bowel movements or bleeding increases, jaundice (yellow eyes and skin with dark urine) develops, vomiting begins, or pain increases.

Special Notes: