Ulcerative colitis results in rectal pain and bleeding due to inflammation in the digestive tract. Learn about other symptoms, diet plan, Treatment Options, and more.
Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD), which is a group of disease that affects your gut, that results in chronic inflammation in your gastrointestinal tract. This inflammation can result in sores or ulcers in the colon.
As it is a chronic condition, it progresses slowly, and symptoms develop late. It affects the innermost lining of the rectum and colon. It is a debilitating condition and can result in life-threatening complications. As of now, there is no cure, and treatment aims at relieving the signs and symptoms.
This inflammation increases gastric motility, which causes frequent bowel movements. Ulcers are formed as the cells of the lining of your bowel die. These ulcers can bleed. Most people affected are between ages 15 and 35 or older than 50 years.
The severity of the disease changes over time, and different individuals experience varying degrees of symptoms. The common symptoms of ulcerative colitis are:
Blood in stools.
Unintentional weight loss.
Pain in the rectum.
Joint swelling and pain.
Most people have periods of mild or no symptoms (remission) and periods of severe symptoms (flare-up).
It was believed that our diet and too much stress results in UC, but now it is understood that they only aggravate the condition and not cause it. The exact cause is still not known. Doctors now think that when our immune system fights off infection, it also attacks the normal cells in the gastrointestinal tract causing UC. It has also been seen that genetics and family history all seem to play a role.
The risk factors are:
Family history - 12 % of people suffering from UC have a positive family history.
Race - It can affect people of any race, but it more commonly affects Caucasians.
Certain drugs - The use of Isotretinoin is said to cause UC.
Age - It can affect people of any age, but commonly seen in people between the ages of 15 and 30 and older than 60 years.
Ulcerative colitis is classified according to its location, and the types are:
Ulcerative proctitis - Inflammation in and surrounding the rectum (anus). It is the mildest form and can cause rectal bleeding.
Proctosigmoiditis - Inflammation of the anus and lower end of the colon (sigmoid colon). It causes dysentery, stomach cramps and pain, and tenesmus (the inability to empty the bowel even with an urge).
Left-sided colitis - Inflammation of the rectum, sigmoid and descending colon. It results in dysentery, left-sided stomach cramping and pain, and weight loss.
Pancolitis - Inflammation of the entire colon. It causes severe blood loss in stool, stomach cramps and pain, tiredness, and unintentional weight loss.
Acute severe ulcerative colitis - Inflammation of the entire colon. It results in severe abdominal pain and diarrhea, blood in stools, etc.
Many conditions can result in symptoms similar to UC. So to rule out all other possible causes, your doctor might suggest you undergo the following tests:
Blood tests - To check for anemia and infection. Severe rectal bleeding can result in anemia.
Stool test - Stool sample is checked for the presence of white blood cells (seen in UC), and to rule out bacterial, viral, and parasitic infections.
Colonoscopy - A thin and flexible tube with a camera and light attached to one end is inserted into the rectum to view the entire colon. If needed, a tissue sample from the lining of the colon is also taken.
Sigmoidoscopy - In cases of severe inflammation of the colon, a very thin and flexible tube is used to examine the rectum and sigmoid instead of performing a colonoscopy.
X-ray of the abdomen - To rule of perforation of the colon.
CT scan of the pelvis and abdomen - To detect the severity of colon inflammation and to rule out other complications of UC.
Ulcerative colitis is either treated with the help of medicines or surgery.
Depending on the severity of the condition, the drugs used are:
5-aminosalicylates - Sulfasalazine, Mesalamine, and Balsalazide.
Corticosteroids - Prednisone and Hydrocortisone.
Azathioprine and Mercaptopurine.
Infliximab and Adalimumab.
Anti-diarrheal medications - Loperamide.
Painkillers - Paracetamol, Ibuprofen, and Diclofenac sodium.
Always consult a doctor before taking any medication, as the medicines that work for others might not work for you.
In severe cases, surgery is done to remove the entire colon and rectum, which is called proctocolectomy. In such cases, to allow the patient to pass motion almost normally and to avoid wearing a bag to collect stool, a procedure called ileal pouch-anal anastomosis is done. Here, the surgeon constructs a pouch and attaches it to the small intestine and anus.
If ileal pouch-analpouch anal anastomosis is not possible, the doctor attaches a bag to your abdomen, where the stool gets collected.
Probiotics - Probiotics are beneficial bacteria usually found in the digestive tract. Adding more probiotics in your diet might help fight this disease.
Fish oil - It acts as an anti-inflammatory.
Aloe vera - It also has anti-inflammatory properties.
Acupuncture - It is done by inserting fine needles into specific points in the body.
Psyllium husk - Helps in regular bowel movement.
Bromelain - It is an enzyme found in pineapple and helps in reducing inflammation.
Turmeric - It is an antioxidant and reduces inflammation.
Always consult your doctor before trying any natural treatment, as it can make your condition worse.
Consume a low-fat diet.
Include more vitamin C in your diet.
Consume a fiber-rich diet.
Maintain a food diary.
Some of the possible complications of UC are:
Severe rectal bleeding.
The intestinal walls thicken.
Increased risk of blood clots.
Rarely, liver disease.
Inflammation of the skin, joints, and eyes.
Toxic megacolon (rapid swelling of the colon).
Medicines and home remedies will only help relieve symptoms to some extent, and the only cure is the removal of the colon and rectum. Surgery is done only if you develop some severe complications. To know more about this condition, consult a gastroenterologist online now.
As of now, there is no permanent cure for ulcerative colitis. Medicines are used to relieve symptoms and keep the disease in remission. In cases that result in severe inflammation of the colon or other complications, the entire colon and rectum are surgically removed.
It is a chronic or long-lasting condition that can result in fatal complications like perforated colon, colon cancer, and toxic megacolon (rapid swelling of the colon) if left untreated.
Ulcerative colitis can result in severe abdominal and rectal pain, which lasts for a long time. It also causes abdominal cramps.
Drinking warm water with lemon juice in the morning is said to be helpful for ulcerative colitis. To prevent dehydration and kidney stones, it is necessary to drink a lot of water.
Some foods that heal ulcerative colitis are walnuts, olive and coconut oil, and egg yolks, as they contain linoleic acid. Omega-3 fatty acids commonly found in fatty fish and fish oil is also helpful. Probiotics also help in reducing inflammation. Using turmeric and psyllium husk might also help with the symptoms.
The early symptoms of ulcerative colitis are abdominal pain and cramps, blood in stools, fever, weight loss, rectal pain, and tiredness.
Surgery is done to remove the entire colon and rectum. You will need to stay in the hospital for around a week after the surgery, and it will take approximately 4 to 6 weeks to recover.
To treat ulcerative colitis, either the colon or rectum or both are surgically removed. UC does not recur after surgery.
The exact cause is not known, but when the body’s immune system fights off bacteria or virus, it sometimes attacks the normal cells of the gastrointestinal tract, which results in colitis. Some believe that genetics can also cause UC.
Last reviewed at:
09 Jun 2022 - 5 min read
Query: Hi doctor, I am a 27-year-old male. For the past five years I have ulcerative colitis. My main problem is bleeding form rectum. When I take Prednisolone, I am fine for maximum of three months and after that again it starts bleeding and also continues with Mesacol. I also took Azathioprine (Aazo... Read Full »
Query: Hi doctor,I am 23 years old with a weight of 52 kilograms and a height of six feet. I was diagnosed with ulcerative colitis last year. I had an E.coli infection four years back by food poisoning. I have symptoms of rectal bleeding, nausea, and constipation. When I got acute colitis, I took Pentasa s... Read Full »
Query: Hello doctor, Doctors are switching between whether I have Crohn’s or ulcerative colitis, based on the response to the treatment and medicine. I started Humira last month, but it has come in for my second round, and it is already a month late. I do not know if that worked or not since I am of... Read Full »
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