Some symptoms won’t go away: abdominal pain, rectal bleeding, and frequent diarrhea. Then there is weight loss and a loss of appetite. After a series of tests, the term Ulcerative Colitis (UC) is given as a diagnosis. What is it? UC is an Inflammatory Bowel Disease (IBD), an umbrella term for conditions that cause swelling and inflammation around the digestive tract. It is a chronic disease that impacts the large intestine, which is the colon’s lining. When it becomes inflamed, tiny openings or sores develop. The tricky thing is that there is no known cause; it results from genetics, the immune system, and the environment.
While IBD primarily impacts the white population in the US, there has been a sharp increase in communities of color over the past decade.
We also have more barriers to care, including access to specialists, follow-up care, symptom and disease activity control, and emotional support.
How is Ulcerative Colitis Diagnosed?
A patient’s HCP may need to rule out other things before getting the UC diagnosis. They may order blood tests, a stool study, or a colonoscopy.
With the colonoscopy, the doctor can biopsy one of the sores or ulcers and arrive at a final diagnosis.
And there are two peak age groups where most diagnoses occur:
- Between the ages of 15 and 30 (the average age if you are Black is 38, because we are always diagnosed later)
- Between 50 and 70
Types of Ulcerative Colitis
The Cleveland Clinic describes the types of Ulcerative Colitis as follows:
- Ulcerative proctitis affecting the rectum
- Inflammation affecting the rectum and sigmoid colon (the lower S-shaped part of the colon)
- Left-sided colitis: inflammation affects the left side of the colon
- Pancolitis: inflammation affects the entire colon
Ulcerative Colitis may present as mild, moderate, or severe depending on symptoms.
Ulcerative Colitis Treatments
Any patient diagnosed with UC should work with their HCP to find the best course of treatment. Resources like CrohnsColitisfoundation.org can also be great for newly diagnosed patients. However, medicine is often the first course of treatment.
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Aminosalicylates (5-ASA) may be recommended for mild to moderate UC cases
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Corticosteroids might be recommended for moderate to severe UC cases
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Immunomodulators may be prescribed to address ongoing inflammation
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Biologic/Biosimilar Therapies: Biologics are another option for moderate to severe UC patients
In about 1/3 of patients, medicine is not enough, and they opt for the total removal of the colon and rectum.
According to the Washington University Department of Surgery in St. Louis, two different surgical approaches may be used. The first involves removing the entire colon and rectum and creating an ileostomy or external stoma (an opening in the abdomen through which wastes are emptied into a pouch attached to the skin).
A newer and most common option includes removal of the colon and rectum, but doesn’t require a permanent ileostomy. An internal pouch is created from the small bowel, and it is attached to the anal sphincter muscle. The patient doesn’t have to wear an external device/stoma permanently.
When patients opt for these procedures, they are cured of UC.
Additional Resources:
CrohnsColitisFoundation
Healthline
Mayo Clinic
Cleveland Clinic
Washington University Department of Surgery
MyCrohnsColitisTeam
