What is Ulcerative Colitis?

Ulcerative colitis is a disease that causes inflammation (swelling and pain) of the lining of the colon (large intestine) or rectum.

Ulcerative colitis can be divided into several types, depending on which area of the rectum and colon it affects (find out more about the digestive system here).

Table 1: Types of Ulcerative Colitis
Inflamed area: Medical name:
Rectum Proctitis or ulcerative proctitis
Rectum and lower end of colon Proctosigmoiditis
Whole part of the colon on the left side of the abdomen

Distal ulcerative colitis or just distal colitis

Affecting more than the left colon, usually the entire colon Pancolitis
Affects the entire colon and causes severe pain, profuse diarrhea and, sometimes, dehydration and shock. This is a rare and life-threatening form of colitis Fulminant colitis

Who gets ulcerative colitis?

Table 2: Who gets ulcerative colitis1
Europe 0.6 to 24.3 per 100,000 people
Asia and Middle East 0.1 to 6.3 per 100,000 people
North America 0 to 19.2 per 100,000 people
Ages Can develop at any age, but most commonly starts between the ages of 30 and 40
Males or females Women and men equally

Symptoms

The most common symptoms are:

  • Abdominal pain - This can be crampy, usually on the left side (as the colon runs along the left side of your body)
  • Diarrhoea – As the intestinal lining becomes more inflamed and ulcerated, it loses its ability to absorb water from the waste material that passes through the colon leading to diarrhoea
  • Blood or mucus stools - The damaged, ulcerated intestinal lining can also produce a lot of mucus and blood, which are deposited into the stools  

Other symptoms depend on whether you have a mild, moderate or severe form of the disease.

Table 3: Symptoms of Ulcerative Colitis
  Mild Moderate Severe
Blood in the stools Present Present Present with a lot of pus (material). Bloated stomach, air in the intestines. Fever and generally feeling unwell
Stool type Grainy Watery Diarrhoea
Bowel movements A few times a day Frequent Very frequent. Constant defacation urge
Urgency to defacate Present Present Present
Other symptoms   Urge to go to the toilet when no stool is present (tenesmus). May feel tired or listless Urge to go to the toilet when no stool is present (tenesmus). Fever, loss of weight, persistent abdominal pain (especially on the left side), bloatedness, fatigue

Eventually, blood loss may lead to anaemia. Diarrhoea and abdominal pain can make you lose your appetite and lose weight. These symptoms also can produce fatigue, which is a side effect of anaemia as well.

With treatment, the symptoms recede gradually over a period of weeks or months. People with ulcerative colitis may also experience constipation, which can result in bouts of abdominal pain and bloatedness.

Children with ulcerative colitis may fail to develop or grow properly. With treatment, the symptoms recede gradually over a period of weeks to months. If you have ulcerative colitis, you may also experience bouts of constipation in between.

Always contact your medical specialist immediately if you have:

  • Pain, ulcers or tender swelling in the rectum
  • If you experience an acute (sudden) worsening of complications
  • If your stomach area is very bloated, or if you have abdominal pains, vomiting or constipation you may have an intestinal obstruction.

References
1) Molodecky, N.A., Soon, I.S., Rabi, D.M., Ghali, W.A., Ferris, M., Chernoff, G., Benchimol, E.I., Panaccione, R., Ghosh, S., Barkema, H.W., et al. (2012). Increasing Incidence and Prevalence of the Inflammatory Bowel Diseases With Time, Based on Systematic Review. Gastroenterology 142, 46–54.e42.

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