Ulcerative colitis (UC) is a type of inflammatory bowel disease that causes chronic inflammation of the large intestine. UC affects only the large intestine in the digestive system.
The exact cause of UC is not known. There is something called hygiene hypothesis which goes like this-as the societies are living in cleaner and more hygienic environment, our guts become very sensitive to any small infection. So, when it gets exposed to an infection, the immune system goes into overdrive causing autoimmune reaction and damage to our own cells.
UC affects 1-2 million people in the US, most people develop symptoms before the age 30. It is slightly more common in males. It is more common in Caucasian and people of Ashkenazi Jewish ancestry, less common in people of Asian, African and the South American descent.
The most common symptoms are diarrhea, bloody bowel movements, mucus in the stool, abdominal pain, rectal pain or urgency, fever or weight loss. UC can affect other organs in the body causing a variety of symptoms as described in this graphic.
UC is generally diagnosed by either colonoscopy or flexible sigmoidoscopy with biopsies.
There are many treatment options for UC which may include short course of steroids, anti-inflammatory medications, immunomodulators which act to “dial down” the immune system response. If the disease is severe, Dr. Kethu sometimes uses medications called biologic therapies in the form of shots or as an intravenous infusion.
Chronic and excessive bleeding can lead to iron deficiency anemia.
If the inflammation is very severe, it may lead to perforation of the colon.
Chronic inflammation over a long period of time especially if untreated, may increase the risk of colon cancer.
UC sometimes may cause a chronic liver condition called primary sclerosing cholangitis which may increase the risk of bile duct cancer and may require liver transplantation.