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Ulcerative colitis is a common condition of the colon that affects approximately 1.5 million people in the United States. Ulcerative colitis usually affects young adults (patients in their 20s and 30s), but can affect children and older adults as well.
Ulcerative colitis affects only the colon. The disease is chronic, which means that it is always present, although the inflammation may come and go. Patients typically will have periods of active symptoms ("flares") followed by symptom-free periods ("remission"). The symptoms can have a negative impact on quality of life for patients.
No medicines will cure a patient; therefore, patients must deal with the illness for their entire lifetime unless the colon is removed. However, most patients continue to work and have productive lives.
Symptoms of Ulcerative Colitis
- Bloody diarrhea
- Abdominal pain
- Visual problems (blurred vision, red eyes or painful vision)
- Joint pain or swelling
- Skin rashes
- Liver problems
Diagnosis of Ulcerative Colitis
Many different tests are used to diagnosis patients with ulcerative colitis. Patients are given a complete history and physical exam. Although blood tests are required, these alone cannot diagnosis ulcerative colitis. A colonoscopy is required to confirm the diagnosis of ulcerative colitis.
Treatment of Ulcerative Colitis
Current therapies to treat patients with ulcerative colitis include aminosalicylates ("5-ASA"), steroids, immune suppressants, and biologic therapy (medications that block specific inflammatory molecules important in ulcerative colitis). For some of these drugs, treatments are available in pill form, suppositories, enemas, injections under the skin, and intravenous infusions. Although medical treatment can be effective in controlling the symptoms of ulcerative colitis, patients must take medications continuously to prevent the symptoms from returning.
Although some patients require a ileostomy (bag attached to the belly wall that collects fecal waste) after colectomy, another surgical procedure can be performed in many patients later to reverse the ostomy called a restorative proctocolectomy or J pouch. This procedure allows patients to have bowel movements without an ostomy.
There have been many advances in surgery for ulcerative colitis. The most significant are development of restorative proctocolectomy and use of minimally invasive surgery (laparoscopy).
Changing your diet, especially during flares, may ease your symptoms. It will not reduce inflammation, nor will it lower your risk for complications.
Herbal, alternative, or complementary therapies have not been proven to work in clinical studies, nor have they been fully tested. Although some help ease symptoms, they usually work only in very mild cases or as a supplement to existing therapy. Ask your health care team about the safety and effects of these products. Always let your health care team know if you are using them.