What You Should Know About Ulcerative Colitis

Ulcerative colitis is a condition that is still stumping the very best doctors in the world. We know more about it now than ever before, and yet we still don't know what causes ulcerative colitis or how to cure it. For the newly diagnosed, the amount of information available can be overwhelming, and yet basic questions often go unanswered. Following is my top 10 list of what everyone with ulcerative colitis should know about this condition. 

Ulcerative colitis is one of the two main forms of inflammatory bowel disease (IBD). The other is Crohn's disease. These two diseases have similar symptoms and are treated by some of the same drugs, but are actually quite different. It is important to know which form of IBD is present before a treatment plan can be devised. There is no cure for either form of IBD. It is a chronic, lifelong condition.

Ulcerative colitis is known as an idiopathic disease, or a disease with an unknown cause. There are, however, several theories about the origins of ulcerative colitis and conditions that may contribute to its development. Most recently, more than 100 genes have been shown to be associated with the development of IBD. None of these theories are yet proven, and much more study will need to be completed before there is a definitive answer.

The hallmark symptoms of ulcerative colitis include:

• Bloody diarrhea
• Mucus in the stool
• Fever
• Abdominal pain
• Weight loss
• Lack of appetite

Ulcerative colitis can also cause symptoms outside of the large intestine. Some of these extra-intestinal conditions include:

• Eye inflammation
• Joint pains
• Skin rashes or lesions
• Mouth ulcers

In the past, it was widely believed that there was a psychological component to IBD. Older studies that showed that stress and psychological problems played a role in the development of IBD have remained unconfirmed. This is a case where the latest research has shown that much earlier studies may have been flawed, because their results can not be reproduced. There is no direct connection between IBD and mental disorders. Unfortunately, many people still believe the false IBD/stress connection.

Former smokers are at the highest risk for developing ulcerative colitis, while current smokers are at the least risk. This indicates that something about smoking cigarettes (most likely the nicotine) may prevent the expression of ulcerative colitis. Of course, it is not recommending that anyone smoke to prevent or treat ulcerative colitis, and studies using nicotine patches as a treatment for ulcerative colitis have not shown good results. 

The risk of colon cancer increases after 8 to 10 years of active ulcerative colitis. People with ulcerative colitis primarily in the rectum have the lowest risk of developing colon cancer; disease in just part of the colon involved carries an intermediate risk; disease in the entire colon has the greatest risk. However, keep in mind that more than 90% of IBD patients never develop colon cancer.

Most of the time, ulcerative colitis is treated medically, through use of various drugs or combinations of drugs. However, a certain portion of people with ulcerative colitis will not respond to drug therapy, and will continue having symptoms even during treatment. Others may be at a high risk for colon cancer after having the disease for a number of years. In those cases, a type of surgery called ileal pouch-anal anastomosis (IPAA), more commonly known as a j-pouch, may be done. If a j-pouch is not a viable option, ileostomy surgery is also an option for treating ulcerative colitis.

A healthy pregnancy and baby are both possible. Fertility rates for women with IBD are the same as women who are in good health. For women whose ulcerative colitis is in remission, the risk of miscarriage, stillbirth and congenital abnormality are the same as that for healthy women.

Antidiarrheal medications are associated with a risk of toxic megacolon. It is generally advised that these medications should only taken by persons with ulcerative colitis under the close supervision of a physician.

Ready to know more in-depth information about ulcerative colitis? See this introduction to ulcerative colitis, which contains links to much more in-depth information about all the topics discussed here, and more.