digestive disorders
Ulcerative Colitis
Introduction
Ulcerative colitis is a chronic inflammatory bowel disease in which the large intestine (colon) becomes inflamed and ulcerated (pitted or eroded), leading to flare-ups (bouts or attacks) of bloody diarrhea, abdominal cramps, and fever. The long-term risk of colon cancer is higher than in people who do not have ulcerative colitis. The exact cause of this disease is not known. Typical symptoms during flare-ups include abdominal cramps, an urge to move the bowels, and diarrhea (typically bloody). The diagnosis is based on a sigmoidoscopy or sometimes a colonoscopy. People who have had ulcerative colitis for a long time are at increased risk for colon cancer. Treatment is aimed at controlling the inflammation, reducing symptoms, and replacing any lost fluids and nutrients. (See also Overview of Inflammatory Bowel Disease (IBD) .) Ulcerative colitis may start at any age but usually begins before age 30, usually between the ages of 14 and 24. A small group of people have their first attack between the ages of 50 and 70. Ulcerative colitis usually starts in the rectum (ulcerative proctitis). It may stay confined to the rectum or over time extend to involve the entire colon. In some people, most of the large intestine is affected at once. Ulcerative colitis usually does not affect the full thickness of the wall of the large intestine and hardly ever affects the small intestine. The affected parts of the intestine have shallow ulcers (sores). Unlike Crohn Disease , ulcerative colitis does not cause fistulas or abscesses. The cause of ulcerative colitis is not known for certain, but heredity and an overactive immune response in the intestine seem to be contributing factors. Cigarette smoking, which seems to contribute to the development and periodic flare-ups of Crohn disease, seems to decrease the risk of ulcerative colitis. However, smoking in order to reduce the risk of ulcerative colitis is ill-advised in light of the many health problems that smoking can cause. 