Ulcerative colitis

Ulcerative colitis is a chronic inflammatory bowel disease affecting the lining of the colon.

Overview

Ulcerative colitis is a chronic inflammatory bowel disease affecting the lining of the colon. The cause is unknown. The disease is intermittent in nature, with alternative phases of relative well-being and episodes of cramp-like abdominal pain and slimy and bloody diarrhoea. There are no known diets or other measures to prevent this disease.

Symptoms

  • Course
    • First episode begins gradually or becomes acute within a few days, and continues for four to eight weeks
    • This is followed by several months or even several years of remission
    • Sometimes the disease is chronic from the outset
    • In 50% of cases, the inflammation is confined to the lower part of the colon
    • Other cases: the inflammation moves higher up the colon, until approx. 20% of the colon is affected
  • Main symptom: bloody and slimy diarrhoea
    • Up to 20 bowel evacuations per day
  • Cramp-like pain in the lower abdomen and rectal area
    • Continues during bowel evacuations
    • Painful urge to empty the bowels (tenesmus)
    • Pain is usually worst on the left side
  • Nausea, bloating and loss of appetite
    • Weight loss
  • Fatigue, drop in performance
  • Malnutrition
  • Less often: fever, racing heart (tachycardia)
Other risks and long-term consequences
  • Concomitant disorders of other organs in 10 to 20% of cases (less often than with Crohn’s disease)
  • Arthritis and osteoporosis
  • More rarely, inflammation of the skin, the lining of the mouth, the eyes or the liver
  • Also inflammation of the biliary tract, gallstones, kidney stones
  • Bowel cancer
    • Risk of disease increases over time as the episodes get worse
    • Risk is noticeably higher if the entire colon is affected

Causes and treatment

Causes

  • The causes are currently unknown
  • Genetic factors are suspected
    • Family history: most important independent risk factor
  • The following are also being considered: environmental factors, smoking, diet, food intolerances, psychological stress

Further treatment by your doctor / in hospital

Possible tests
  • Key examination: endoscopic examination of bowel (colonoscopy) with removal of tissue samples
  • Ultrasound (sonography)
  • Blood test
  • MRI (magnetic resonance imaging)
  • CT scan (computed tomography)
Possible therapies
  • Acute attack: very important to follow the diet recommended by a nutrition specialist
  • Infusions: fluid replacement for heavy and severely dehydrating diarrhoea
  • Medication
    • Suppression and modulation of the immune system (e.g. with cortisone, azathioprine, tacrolimus and TNF inhibitors)
    • Antibiotics in very rare cases
    • Period of remission: prevent renewed flare-ups of the disease with medication-based maintenance therapy
  • Reasons to have an operation:
    • No improvement or excessively severe side-effects of medication
    • Bowel perforation (rupture), peritonitis or uncontrollable bleeding

What can I do myself?

  • Diet
    • There are no known diets or other measures to prevent this disease
    • Periods of remission: healthy bowel diets are controversial (judged to be either essential or useless)
    • Patients are advised to identify the diet that suits them best with the help of a nutritional expert
  • For severe illness: look for psychotherapeutic support (recommendation)
  • Patients should carefully observe the progression of the disease
  • Attend a self-help group: tips and support (see “Further information” below)

Get a personal Preventive Care Recommendation now.

When to see a doctor?

  • Recurrent abdominal pain and diarrhoea without any discernible cause
  • Slimy diarrhoea with some blood in the stool
  • Unexplained weight loss
  • If diagnosis has been confirmed:
    • Go to the doctor as soon as the first signs of an attack appear (makes consistent treatment possible)
    • Constant medical supervision and long-term therapy are required
    • Monitor and regularly adjust the therapy
    • This is the only way to identify complications at an early stage
  • Pregnancy and ulcerative colitis
    • Disease does not present a hurdle
    • Attacks or relapses are typical, in particular in the first trimester
    • Constant monitoring by the gynaecologist and gastroenterologist is essential

Further information

Selbsthilfe Schweiz (Self-Help Support Switzerland)
www.selbsthilfeschweiz.ch 

Schweizerische Morbus Crohn/Colitis ulcerosa-Vereinigung (SMCCV) (Swiss Crohn’s & Colitis Association)
www.smccv.ch

Synonyms

ulcerative colitis

Exclusion of liability

CSS offers no guarantee for the accuracy and completeness of the information. The information published is no substitute for professional advice from a doctor or pharmacist.

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