Ulcerative colitis is a long-term condition that causes your large bowel and rectum (back passage) to become inflamed (red and swollen). This causes symptoms like diarrhoea with blood in it, which may come and go. There are lots of treatments that can help control your symptoms.
Ulcerative colitis is one of the main types of inflammatory bowel disease (IBD). The other is Crohn’s disease . In ulcerative colitis, the lining of your large bowel becomes inflamed and develops ulcers. Often, it only affects your rectum (the very end of your large bowel) – this is called proctitis. The affected areas may bleed and produce mucus, which you then pass out when you poo. Crohn’s disease affects any part of your digestive system, from your mouth to your anus.
Most people develop ulcerative colitis either between the ages of 20 and 40, or when they’re older, at around 60. But you can get ulcerative colitis at any time in your life. You’ll usually have ulcerative colitis for the rest of your life. Your symptoms might follow what’s called a ‘relapsing and remitting’ pattern. This means your symptoms can disappear, sometimes for months or even years, and then come back again. This is called a relapse or flare-up. Many people have flare-ups at least once a year, or more frequently.
Ulcerative colitis symptoms usually come and go. You may have periods without any symptoms (known as remission) and periods when they come back (known as a relapse or flare-up). You may feel completely well between flare-ups, with no symptoms at all.
During a flare-up, your symptoms may include:
There’s a chance that you could develop problems in other parts of your body too. For example, you might get mouth ulcers, skin rashes, red or painful eyes, and painful, swollen joints. These problems usually occur during a flare-up, but can also happen while you’re in remission. You may feel anxious too, and your symptoms can have a significant impact on your quality of life. See our Living with section for more information on this.
If you have any of these symptoms, contact your GP for advice.
Your Doctor will ask about your symptoms and examine you. They’ll also ask about your medical history and if any other members of your family have bowel problems. They’ll want to know if you’ve recently travelled abroad, in case your symptoms may be due to an infection. They may ask you for a sample of poo (a stool sample) to check for bacterial infections. It can also be used to look for a marker called faecal calprotectin. This can be raised if you have inflammatory bowel disease. They’ll ask you to have a blood test too.
Depending on the results, your Doctor may refer you to a gastroenterologist. This is a doctor who specialises in conditions that affect the digestive system.
You might need to have more tests, which can include the following.
Treatments for ulcerative colitis can control your symptoms and prevent flare-ups. The treatment you have will depend on several things. These include how severe your ulcerative colitis is and how much of your large bowel is affected. You’ll be cared for by a team of healthcare professionals with specialist knowledge of inflammatory bowel diseases (your IBD team).
You may need to take different medicines when you’re in remission and when you’re having a flare-up. It’s really important to keep taking your medicines as your doctor recommends, even if you’re feeling well.
If you have a severe flare-up of ulcerative colitis, you may need to go into hospital urgently. This is because you’ll need specialist care and intravenous medicines (medicines given directly into your vein).
Medicines for ulcerative colitis include the following.
If you have any questions about taking your medicines, ask your doctor. Let your doctor know if you’re trying to get pregnant, as some medicines for ulcerative colitis can be dangerous in pregnancy .
Surgery for ulcerative colitis involves removing all, or part of your large bowel. There are several reasons why you may have surgery. These include the following.
Around 15 in 100 people with ulcerative colitis have surgery within 10 years of being diagnosed. But this number is reducing all the time, as better treatments are available.
Surgery for ulcerative colitis often involves having something called an ileostomy. This is where your surgeon brings the end of your small bowel out to open on the surface of your abdomen (called a stoma). This is so that your body is still able to get rid of waste products. You wear an ileostomy bag over the opening, to collect the waste. You may need to have a temporary or a permanent ileostomy.
Your doctor will talk to you about what kind of operation is best for you and what’s involved. If you’re considering having surgery, it’s important that you discuss all the pros and cons with your doctor first. The most common types of surgery for ulcerative colitis are briefly described here.
It’s unclear exactly why some people develop ulcerative colitis. It’s thought that it’s probably an autoimmune condition. This means your body’s immune system starts attacking itself. This might be in response to bacteria in your bowel.
Ulcerative colitis runs in families. If you have a close family member with ulcerative colitis, you’re about four times more likely to develop it. Your chance of getting ulcerative colitis may also be affected by your environment and where you live.
Ulcerative colitis can lead to a number of complications.
Ulcerative colitis is a life-long condition that can affect you physically and emotionally. Flare-ups can have a big impact on your social life, education or work. But that doesn’t mean you can’t live life to the full
It’s natural that living with ulcerative colitis can make you feel stressed at times. Stress can sometimes trigger flare-ups so you may find it helpful to try some relaxation techniques. These may include deep breathing, meditation, yoga and mindfulness .
Regular exercise can also help to give you a boost and make you feel better. It can also improve your general health and help to keep your bones and muscles strong. This is important because some medicines for ulcerative colitis may affect your bone health.
Flare-ups can be unpredictable. To help you be prepared, make a flare-up plan with your doctor or nurse. This may involve adjusting the medicines you take, for instance.
If you feel anxious about going out, it can help to plan ahead. Find out where the nearest public toilets are. You may find it useful to carry a card to help with telling people if you need to use the toilet urgently. If you’re worried about not getting to the toilet quickly enough, carry spare clothing in your bag so you can change. You may also want to carry moist wipes, and plastic bags for soiled clothes.
If you’re going on holiday, make sure you have enough medicine to take with you, including any you need for a flare-up. Take extra medication with you if possible, in case of delays, and a doctor’s note to say what they’re for, especially if you’re flying.
Telling your family and friends about your condition and how it affects you may help them to give you the support you need. You’ll also be supported by your IBD team. There will often be a helpline or email you can contact. Keep these to hand, and always seek advice as soon as you need it. Support groups, as well as online chat forums and message boards can also offer a chance to talk to other people having similar experiences. For organisations that can offer reliable information and advice, see our ‘Other helpful websites’ section.
Certain foods can make your symptoms worse. These might include foods that are high in fibre and spicy foods. Try keeping a food diary to help identify problem foods. It’s very important to eat a healthy balanced diet, so don’t make any major changes without talking to your doctor or dietician first.
Only surgery to remove all or part of your bowel can completely cure ulcerative colitis. But there are many treatments available that can help to keep your condition under control. See our Treatments section for more information.
Your risk of developing ulcerative colitis is higher if a close family member has it. But having a family member with ulcerative colitis doesn’t mean you will definitely get it. It’s likely to be caused by a combination of factors. See our Causes section for more information.
Ulcerative colitis can often come on very slowly and gradually. You might notice bleeding and passing mucus from your bottom first. You may have diarrhoea and pains in your tummy too. See our symptoms section for more information.
· Crohn’s and Colitis UK
www.crohnsandcolitis.org.uk
· Guts UK
www.gutscharity.org.uk
· Colostomy UK
www.colostomyuk.org
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