Ulcerative Colitis: A Guide to Symptoms, Diagnosis and Management
What is Ulcerative Colitis (UC)?
Ulcerative colitis (UC) is the most common type of inflammatory bowel disease (IBD), where parts of the large bowel such as your rectum and colon becomes swollen, inflamed and ulcerated.1 This can lead to diarrhoea, blood in stool, weight loss, fatigue and stomach pain, among other symptoms, however everyone can experience UC differently.2 UC can be diagnosed at any age, although it most commonly occurs between the ages of 20-40 years.1
UC occurs when the body’s immune system starts attacking the bowel, however when it comes to the exact cause of UC there's still a lot we don't know.1
There are different types of UC, depending on what part of the colon is affected. The most common types are:3
Proctitis
Inflammation of the bowel that is confined to the rectum (the final section of the large intestine that ends in the anus).
Proctosigmoiditis
Affects the rectum and the part of the colon next to the rectum called the sigmoid colon.
Left-sided or distal colitis
Inflammation that is found in the distal colon, this includes the rectum and the left side of the colon, also called the descending colon.
Total Colitis or Pancolitis
Affects the whole colon, if the inflammation affects most but not all of the colon it is referred to as extensive colitis.
Ulcerative Colitis Symptoms
The symptoms of ulcerative colitis (UC) depend on the severity and extent of the disease, as well as on which part of the colon is affected.2 The likelihood of developing UC is almost the same for women and men and therefore, may not be linked to biologic gender.3 For most people living with IBD, the disorder can occur at any age, but most people are diagnosed between the ages of 20-40 years.1
The main symptoms of UC are:1
Diarrhoea
Rectal bleeding – visible blood in the stools
Urgency to defecate
Constipation
Generally feeling discomfort or weakness
Fever
Loss of appetite and weight loss
Fatigue (tiredness)
Abdominal pain
However, the symptoms that occur in people with UC are very diverse. At the beginning of the diagnosis, there may only be unspecific symptoms in the gastrointestinal area that seem harmless.2 If they occur more frequently and with increasing intensity, they can also be serious signals of IBD.2 Some people may also develop anaemia (a low number of red blood cells) or problems with their joints, skin and eyes.1
Remember to always talk to your healthcare professional to get advice if you are experiencing symptoms, especially if there has been a sudden change.
How Is Ulcerative Colitis Diagnosed?
Getting a diagnosis for UC can be difficult, and you may need several tests, including a physical examination as well as blood and stool tests.4 If you suspect you may have IBD symptoms, consult your healthcare provider. They will ask you about your symptoms, general health and medical history. It is possible that some of the symptoms you may be dealing with can leave you feeling embarrassed or distressed.
Medical history
Your healthcare team will as a first step take a full medical history including information about your overall health, diet and nutrition, when your symptoms first started, what medication you have taken, and your family history.14
Physical Examination
Your healthcare team will conduct a physical examination of the body. This can include your general wellbeing, measuring your heart rate, blood pressure, as well as an abdominal examination.14
Blood and Stool Test
A full blood test can show whether you have inflammation anywhere in your body and if you’re anaemic.
Your stool can also be tested for signs of bleeding or inflammation, and to check whether an infection is causing diarrhoea. A faecal calprotectin test showcases whether you have inflammation in your gut.14
Endoscopy and Biopsy
Two further tests are performed to determine the cause of the symptoms and establish a diagnosis: an endoscopy and a biopsy. An endoscopy is a non-surgical technique that can involve either a) the insertion of a long, flexible tube (endoscope) through the mouth or the anus depending on where the healthcare professional wants to look that contains a tiny video camera, or b) the patient swallowing a tiny camera.14
Treating Ulcerative Colitis
Though there is currently no cure for UC, there are treatments available to help keep the symptoms at bay and help to prevent long term problems.15 Medication for UC can suppress the inflammation of the colon and allow the tissue to heal.5 This can reduce symptoms such as diarrhoea, bleeding, and abdominal pain.5
Surgery
In some cases, surgery may be offered if other treatments are not controlling your symptoms or if you develop severe complications.5
Remember to always talk to your healthcare professional to get advice if you are experiencing symptoms, especially if there has been a sudden change.
It is important to remember that you are not alone, and there is support available to help you.
Visit the IFCCA website to explore resources and connect with others: Go to IFCCA Website
IFCCA
The International Federation of Crohn's & Ulcerative Colitis Associations (IFCCA) represents 46 national Crohn’s and Ulcerative Colitis (IBD) patient associations. IFCCA are an organization of people united in our commitment to improve the life of over 10 million people living with IBD worldwide (3.4 million in Europe alone) and to give them a louder voice and more visibility. Want to find out more about how to manage your IBD?
Living with Inflammatory Bowel Disease (IBD)
Daily Life, Diet and Support
Treating Inflammatory Bowel Disease
Understanding Your Options for Relief and Long-Term Management
What Is Endoscopic Healing?
Procedure, Purpose and What to Expect
