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Ulcerative colitis

Ulcerative colitis makes swelling, inflammation, and sores in the lining of the large intestine (colon) and causes diarrhea, belly pain, and bleeding from the rectum. It's a lifelong condition, but in most people the symptoms come and go.

Medicines can stop or reduce symptoms and prevent flare-ups. If the disease is severe, you may need surgery to remove the colon.

  • Symptoms

    What are the symptoms of ulcerative colitis?

    The main symptoms of ulcerative colitis are:

    • Belly pain or cramps.
    • Diarrhea.
    • Bleeding from the rectum.

    Some people also may have a fever, may not feel hungry, and may lose weight. In severe cases, people may have diarrhea 10 to 20 times a day.

    The disease can also cause other problems, such as joint pain, eye problems, or liver disease.

    In most people, the symptoms come and go. Some people go for months or years without symptoms (remission) and then have a flare-up. A few people have symptoms all the time.

  • Causes

    What causes ulcerative colitis?

    Experts aren't sure what causes ulcerative colitis. It might be caused by the immune system overreacting to normal bacteria in the digestive tract. Or other kinds of bacteria and viruses may cause it. You are more likely to get it if other people in your family have it.

  • Diagnosis

    How is ulcerative colitis diagnosed?

    To diagnose ulcerative colitis, a doctor will ask about your symptoms, do a physical exam, and do a number of tests. Testing can help rule out other problems that can cause similar symptoms, such as Crohn's disease and irritable bowel syndrome.

    Tests that may be done include:

    • Colonoscopy. In this test, a doctor uses a thin, lighted tool to look at the inside of your entire colon. At the same time, the doctor may take a sample (biopsy) of the lining of the colon.
    • Blood tests to check for infection or inflammation.
    • Stool sample testing to look for blood, infection, and white blood cells.
  • Treatment

    How is ulcerative colitis treated?

    Treatment for ulcerative colitis depends mainly on how bad the disease is. Your doctor will help you find treatments that reduce your symptoms and help you avoid flare-ups. Options include:

    Medicines.
    • If your symptoms are mild, you may only need to use over-the-counter medicines for diarrhea (such as Imodium). Talk to your doctor before you take these medicines.
    • Many people need prescription medicines, such as steroid medicines or other medicines that reduce the body's immune response. These medicines can stop or reduce symptoms and prevent flare-ups.
    Changes in your diet.

    If certain foods make your symptoms worse, it makes sense to not eat those foods. But be sure to eat a healthy, varied diet to keep your weight up and to stay strong.

    Surgery.

    If you have severe symptoms and medicines don't help, you may need surgery to remove your colon. This cures ulcerative colitis. It also prevents colon cancer.

  • When to call

    Ulcerative colitis: When to call

    Call 911 anytime you think you may need emergency care. For example, call if:

    • Your stools are maroon or very bloody.
    • You passed out (lost consciousness).

    Call your doctor now or seek immediate medical care if:

    • You are vomiting.
    • You have new or worse belly pain.
    • You have a fever.
    • You cannot pass stools or gas.
    • You have new or more blood in your stools.

    Watch closely for changes in your health, and be sure to contact your doctor if:

    • You have new or worse symptoms.
    • You are losing weight.
    • You do not get better as expected.
  • Self-care

    Caring for yourself when you have ulcerative colitis

    You can take steps at home to reduce symptoms of ulcerative colitis and take care of yourself.

    • Take over-the-counter medicines.

      If you have only mild symptoms, antidiarrheal medicines may help. For disease in the rectum alone, you can try medicines given in a suppository, enema, or foam.

    • Avoid medicines that can make ulcerative colitis worse.

      In general, doctors recommend that you don't use nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen). These medicines may cause flare-ups. But some people may be more likely to have flare-ups from NSAIDs than other people. Talk to your doctor about whether to avoid these medicines.

    • Change your diet.

      A change in your diet may help reduce symptoms. Keep a food diary to find out which foods make your symptoms worse. During a flare-up, avoid or reduce these foods.

      Instead of cutting out a whole group of high-nutrient foods, try replacing them with healthy choices.
    • Get support.

      Ulcerative colitis can affect every aspect of your life. You may want to seek counseling or social support from family, friends, or clergy. Or look for a support group.

    • Learn about ostomy care.

      If you have had or are planning to have surgery that will create an ostomy, you may feel self-conscious or embarrassed. After a period of adjustment, most people are able to resume all of their usual activities. In fact, you may feel better than before surgery because you may no longer have painful symptoms. Support groups are available for people with ostomies.

    Children tend to have a harder time than adults in managing the disease. So the support of a parent is very important.

    Children may feel self-conscious if they don't grow as fast as other children their age. Encourage your child to take medicine as prescribed. Offer your help with the treatment so that your child can feel better, start growing again, and lead a more normal life.


    Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.