Ulcerative colitis (UC) is a chronic condition that is characterised by bouts of abdominal pain, diarrhoea and urgency to use the toilet. UC is one of the two main forms of inflammatory bowel disease—the other being Crohn’s disease. With this long-term disorder, small ulcers can develop in the large intestine (bowel) and the rectum. These ulcers can sometimes bleed and produce mucus, proving to be very painful for the sufferer. Other symptoms include loss of appetite, rapid weight loss, excessive tiredness, high temperature and general feelings of being unwell. People with UC often experience long periods of good health known as remission, as well as relapses—also known as flare-ups—where symptoms are amplified or more frequent.
Although there has been vast research into the topic, it still isn’t completely clear what causes UC. UC is thought to be an autoimmune condition caused by irregularities in the immune system, the body’s natural defence against infection. This theory stipulates that the immune system mistakenly identifies harmless bacteria inside the colon as dangerous and proceeds to attack the healthy tissue—causing inflammation. The reason behind this reaction still remains unknown, although most believe it’s a combination of genetic and environmental factors. According to the NHS, more than one in four people with UC have a family history of the condition.
UC can start at any time, though it often appears between the ages of 15 and 25 or in later life—between the ages of 55 and 65. Medical sources tend to agree that the condition affects men and women equally. The risk of developing UC is said to be greater if a close family member also suffers from it, making genes a considerable factor. The significance of genes is further supported by the fact that UC is common in white people of European descent and rarer in people of Asian backgrounds. UC is predominant in urban areas and developed countries, although the number of those affected in developing nations is steadily increasing.
When UC flare-ups rear their ugly head, other parts of the body can be affected too. Common signifiers of a flare-up include:
- Painful or swollen joints
- Sore and irritated eyes
- Mouth ulcers
- Patches of painful or swollen skin
In more severe cases flare-ups may also include symptoms such as:
- Irregular heartbeat
- Shortness of breath
- Blood in the stool
There is no definitive cure for UC, but treatments are designed to relieve symptoms and stop them from returning—this is known as ‘maintaining remission’. For most patients, maintaining remission can be achieved through certain medications such as aminosalicylates (ASAs), corticosteroids and immunosuppressants. Mild to moderate symptoms can be treated at home with such medicines, while severe flare-ups may require treatment in hospital. Serious cases of UC can cause the colon to stretch, become enlarged or develop a hole; in such cases, close medical attention will be necessary. If one’s quality of life is being affected and medications aren’t tackling the problem effectively, a portion of the intestine may be removed via surgery.
If you suspect that you are suffering from UC, contact your doctor as soon as possible in order to get a definitive diagnosis. A blood or stool sample will help to determine the verdict. If necessary, you may be referred to a hospital for further testing. Once diagnose, your medical practitioner will guide you on a treatment plan that is appropriate for your condition.
1 in 420
The estimated proportion of people affected by ulcerative colitis in the UK, which equates to roughly 146,000 sufferers
In the news
A drug called tofacitinib, which has previously been used to treat rheumatoid arthritis, can now be administered to those with ulcerative colitis. Earlier this year, the Food and Drug Administration (FDA) expanded its approval of the drug, which goes by the brand name Xeljanz. It is now rumoured to become the first oral medication approved for chronic use in the treatment of the inflammatory bowel disease.