Ulcerative Colitis: Causes, Symptoms, and Types

Ulcerative colitis is a chronic condition that occurs when the lining of the colon becomes inflamed and causes ulcers or open sores to form. A type of inflammatory bowel disease, ulcerative colitis can occur at any age – including in children – and is marked by symptoms like diarrhea, rectal bleeding, and abdominal pain or cramping. The treatment for ulcerative colitis includes medication and, in severe cases, surgery.

Types of Ulcerative Colitis

There are several specific types of ulcerative colitis, depending on its location in the colon:

• Ulcerative proctitis – inflammation is located only in the rectum. Rectal bleeding is the primary – and sometimes only – symptom of this form of the disease.
• Proctosigmoiditis – inflammation is located in the rectum and the lower part of the colon, called the sigmoid colon. The most common symptoms of this form of ulcerative colitis include bloody diarrhea, abdominal pain and cramping on the left side, and the feeling of urgency to defecate.
• Left-sided colitis – inflammation goes from the rectum and includes the sigmoid colon as well as the descending parts of the colon. The most common symptoms of this form of ulcerative colitis are similar to ulcerative proctosigmoiditis.
• Pancolitis – inflammation affects the entire colon. The most common symptoms of this form of ulcerative colitis are similar to left-sided ulcerative colitis but may also include abdominal pain in the middle or on the right side of the abdomen.

Ulcerative Colitis vs. Crohn’s Disease

Ulcerative colitis and Crohn’s disease are often confused because they share some of the same symptoms. Both conditions are forms of inflammatory bowel disease (IBD), but they affect different parts of the gastrointestinal tract. Ulcerative colitis is limited to the colon. Crohn’s disease can affect any part of the gastrointestinal tract, which runs from the mouth to the rectum.

Causes and Risk Factors

The exact cause of ulcerative colitis is unknown, but several risk factors may increase your chances of developing the condition, including:

• Being Caucasian or of Ashkenazi Jewish descent.
• Having a personal history of other autoimmune disease such as psoriasis.
• Having a family history of inflammatory bowel disease.

Although food and stress do not cause ulcerative colitis, they may trigger or worsen symptoms during flare-ups.

Symptoms

The symptoms of ulcerative colitis may vary in frequency and intensity, but generally include:

• Diarrhea, often with blood or pus.
• Rectal bleeding — passing small amounts of blood with stool.
• Abdominal pain and cramping.
• Rectal pain.
• Urgency to defecate.
• Inability to defecate despite urgency.
• Weight loss.
• Fatigue.
• Fever.

See your doctor right away if you have frequent, bloody diarrhea or rectal bleeding – early diagnosis and treatment can help reduce symptoms and complications.

Diagnosis and Treatment 

To diagnose ulcerative colitis, your doctor may recommend:

• Blood tests.
• Stool tests.
• Imaging tests like computed tomography or magnetic resonance imaging.
• Endoscopic tests like colonoscopy or flexible sigmoidoscopy to evaluate the rectum and colon.

Depending on the type of ulcerative colitis you are diagnosed with and the severity of your symptoms, your doctor will likely prescribe a treatment plan that may include medications to manage your disease. In more severe cases, your doctor may recommend surgery.

Preventing Flare-ups 

As you work with your doctor to manage your disease, it is important to take steps to recognize triggers for your condition and make lifestyle changes that reduce the likelihood or severity of any flare-ups. Steps to help prevent flare-ups of your ulcerative colitis include:

• Taking your medications.
• Keeping a food diary so you can be aware of any foods that may trigger a flare-up.
• Avoiding greasy foods and high-fiber foods.
• Avoiding or limiting sugary, carbonated and alcoholic beverages.
• Eating several smaller and lighter meals throughout the day instead of three large ones.
• Limiting dairy products.
• Taking steps to limit stress.
• Exercising, or varying sitting and standing more often, as tolerated.
• Practicing mindful breathing.