Ulcerative colitis – NHS

Ulcerative colitis is a long-term condition where the colon and rectum become inflamed.

The colon is the large intestine (bowel) and the rectum is the end of the bowel where poo is stored.

Small ulcers can develop on the colon’s lining, and can bleed and produce pus.

Symptoms of ulcerative colitis

The main symptoms of ulcerative colitis are:

• recurring diarrhoea, which may contain blood, mucus or pus
• tummy pain
• needing to poo frequently

You may also experience extreme tiredness (fatigue), loss of appetite and weight loss.

The severity of the symptoms varies, depending on how much of the rectum and colon is inflamed and how severe the inflammation is.

For some people, the condition has a significant impact on their everyday lives.

Symptoms of a flare-up

Some people may go for weeks or months with very mild symptoms, or none at all (remission), followed by periods where the symptoms are particularly troublesome (flare-ups or relapses).

During a flare-up, some people with ulcerative colitis also experience symptoms elsewhere in their body; which are known as extra-intestinal symptoms.

These can include:

• painful and swollen joints (arthritis)
• mouth ulcers
• swollen fat under the skin causing bumps and patches – this is known as erythema nodosum
• irritated and red eyes
• problems with bones, such as osteoporosis

In many people, no specific trigger for flare-ups is identified, although a gut infection can occasionally be the cause.

Stress is also thought to be a potential factor.

When to get medical advice

You should see a GP as soon as possible if you have symptoms of ulcerative colitis and you have not been diagnosed with the condition.

They can arrange blood or poo sample tests to help determine what may be causing your symptoms.

If necessary, they can refer you to hospital for further tests.

Find out more about diagnosing ulcerative colitis

If you have been diagnosed with ulcerative colitis and think you may be having a severe flare-up, contact a GP or your care team for advice.

You may need to be urgently admitted to hospital for immediate care.

If you cannot contact your GP or care team, call NHS 111 or contact your local out-of-hours service.

What causes ulcerative colitis?

Ulcerative colitis is thought to be an autoimmune condition.

This means the immune system, the body’s defence against infection, goes wrong and attacks healthy tissue.

The most popular theory is that the immune system mistakes harmless bacteria inside the colon as a threat and attacks the tissues of the colon, causing it to become inflamed.

Exactly what causes the immune system to behave in this way is unclear.

Many experts think it’s a combination of genetic and environmental factors.

Who’s affected

The UK Crohn’s & Colitis UK charity reports at least 1 in every 227 people in the UK has been diagnosed with ulcerative colitis. This amounts to around 296,000 people.

The condition can develop at any age, but is most often diagnosed in people between 15 and 25 years old.

It’s more common in white people of European descent, especially those descended from Ashkenazi Jewish communities, and black people.

The condition is rarer in people from Asian backgrounds, although the reasons for this are unclear.

Both men and women seem to be equally affected by ulcerative colitis.

How ulcerative colitis is treated

Treatment for ulcerative colitis aims to relieve symptoms during a flare-up and prevent symptoms from returning (maintaining remission).

In most people, this is achieved by taking medicine, such as:

• aminosalicylates (ASAs)
• corticosteroids (steroid medicines)
• immunosuppressants

Mild to moderate flare-ups can usually be treated at home. But more severe flare-ups need to be treated in hospital.

If medicines are not effective at controlling your symptoms or your quality of life is significantly affected by your condition, surgery to remove some or all of your bowel (colon) may be an option.

During surgery, your small intestine can be diverted out of an opening in your abdomen known as a stoma. This type of surgery is known as an ileostomy.

In some cases, the stoma is only temporary and can be closed up once your bowel has healed.

An alternative option is to create an internal pouch that’s connected to your anus called an ileoanal pouch.

Read more about treating ulcerative colitis

Complications of ulcerative colitis

Complications of ulcerative colitis include:

• an increased risk of developing bowel cancer
• poor growth and development in children and young people

Also, the steroid medicines used to treat ulcerative colitis can cause weakening of the bones (osteoporosis) as a side effect.

Read more about the complications of ulcerative colitis

IBD or IBS?

Inflammatory bowel disease (IBD) is a term mainly used to describe 2 conditions that cause inflammation of the gut (gastrointestinal tract).

They are:

• ulcerative colitis
• Crohn’s disease

IBD should not be confused with irritable bowel syndrome (IBS), which is a different condition and requires different treatment.

Information:

Social care and support guide

If you:

• need help with day-to-day living because of illness or disability
• care for someone regularly because they’re ill, elderly or disabled (including family members)

Our guide to care and support explains your options and where you can get support.

Page last reviewed: 01 November 2022
Next review due: 01 November 2025

Ulcerative colitis – Treatment – NHS

Treatment for ulcerative colitis depends on how severe the condition is and how often your symptoms flare-up.

The main aims of treatment are to:

• reduce symptoms, known as inducing remission (a period without symptoms)
• maintain remission

This usually involves taking various types of medicine, although surgery may sometimes be an option.

Your treatment will normally be provided by a range of healthcare professionals, including:

• specialist doctors, such as gastroenterologists or surgeons
• GPs
• specialist nurses

Your care will often be co-ordinated by your specialist nurse and your care team, and they’ll usually be your main point of contact if you need help and advice.

Aminosalicylates

Aminosalicylates, also known as 5-ASAs, are medicines that help to reduce inflammation. This in turn allows damaged tissue to heal.

They’re usually the first treatment option for mild or moderate ulcerative colitis.

5-ASAs can be used as a short-term treatment for flare-ups. They can also be taken long term, usually for the rest of your life, to maintain remission.

5-ASAs can be taken:

• orally – by swallowing a tablet or capsule
• as a suppository – a capsule that you insert into your bottom (rectum), where it dissolves
• through an enema – where fluid is pumped into your large intestine

How you take 5-ASAs depends on the severity and extent of your condition.

If you have mild-to-moderate ulcerative colitis, you’ll usually be offered a 5-ASA to take in suppository or enema form.

If your symptoms do not improve after 4 weeks, you may be advised to take 5-ASA in tablet or capsule form as well.

These medicines rarely have side effects, but some people may experience:

• headaches
• feeling sick
• tummy pain
• a rash
• diarrhoea

Corticosteroids

Corticosteroids, such as prednisolone, are an alternative type of medicine used to reduce inflammation.

They can be used with or instead of 5-ASAs to treat a flare-up if 5-ASAs alone are not effective.

Like 5-ASAs, steroids can be administered orally, or through a suppository or enema.

But unlike 5-ASAs, corticosteroids are not used as a long-term treatment to maintain remission because they can cause potentially serious side effects, such as weakening of the bones (osteoporosis) and cloudy patches in the lens of the eye (cataracts), when used for a long time.

Side effects of short-term steroid use can include:

• acne
• weight gain
• increased appetite
• mood changes, such as becoming more irritable
• difficulty sleeping (insomnia)

Find out more about the side effects of corticosteroids

Immunosuppressants

Immunosuppressants, such as tacrolimus and azathioprine, are medicines that reduce the activity of the immune system.

They’re usually given as tablets to treat mild or moderate flare-ups, or maintain remission if your symptoms have not responded to other medicines.

Immunosuppressants can be very effective in treating ulcerative colitis, but they may take a while to start working.

The medicines can make you more vulnerable to infection, so it’s important to report any signs of infection, such as a high temperature or sickness, promptly to a GP.

They can also lower the production of red blood cells, making you prone to anaemia.

You’ll need regular blood tests to monitor your blood cell levels and check for any other problems.

Treating severe flare-ups

While mild or moderate flare-ups can usually be treated at home, more severe flare-ups should be managed in hospital to minimise the risk of dehydration and potentially fatal complications, such as your colon rupturing.

In hospital, you’ll be given medicine and sometimes fluids directly into a vein (intravenously).

The medicines you have may be a type of corticosteroid or an immunosuppressant medicine called infliximab or ciclosporin.

Ciclosporin

Ciclosporin is given slowly through a drip in your arm (an infusion) and treatment will usually be continuous, for around 7 days.

Side effects of intravenous ciclosporin can include:

• an uncontrollable shaking or trembling of part of the body (a tremor)
• excessive hair growth
• extreme tiredness (fatigue)
• swollen gums
• feeling and being sick
• diarrhoea

Ciclosporin can also cause high blood pressure and reduced kidney and liver function, but you’ll be monitored regularly during treatment to check for signs of these.

Biologic medicines

Biologic medicines are medicines that reduce inflammation of the intestine by targeting proteins the immune system uses to stimulate inflammation.

These medicines block these receptors and reduce inflammation.

They may be used to treat moderate to severe ulcerative colitis if other options are not suitable or not working.

Biologic medicines are given in hospital as an infusion through a drip in your arm every 4 to 12 weeks, or as an injection every 1 to 4 weeks.

Your treatment team will then see how you respond to treatment. If your symptoms are under control (remission) for a year or more, they may recommend treatment is stopped.

Biologic medicines affect your immune system and can increase your risk of getting infections. Talk to a GP if you have any symptoms of a possible infection, such as coughs, a high temperature or a sore throat.

Find out more about biologic medicines from Crohn’s & Colitis UK

JAK inhibitors

There are now new types of medicines called JAK inhibitors, such as tofacitinib and filgotinib, that can be used to treat ulcerative colitis.

These work by blocking enzymes (proteins) that the immune system uses to trigger inflammation.

JAK inhibitors can be taken as tablets.

JAK inhibitors may be recommended for people with moderate to severe ulcerative colitis if standard treatments or biologics have not worked, or are not suitable.

JAK inhibitors are not recommended for use in pregnancy. Women should use reliable contraception when taking them, for at least 4 weeks after finishing the course.

Ozanimod

A medicine called ozanimod may be recommended for people with moderate to severe ulcerative colitis if standard treatments or biologic medicines have not worked or are not suitable.

It comes as tablets that you take once a day. You’ll usually take it long term. You’ll have regular checks with your treatment team to see if it’s working well for you.

Ozanimod affects your immune system and can increase your risk of getting infections. Talk to a GP if you have any symptoms of a possible infection, such as coughs, a high temperature or a sore throat.

Find out more about ozanimod from Crohn’s & Colitis UK

Surgery

If you have frequent flare-ups that have a significant effect on your quality of life, or you have a particularly severe flare-up that’s not responding to medicines, surgery may be an option.

Surgery for ulcerative colitis involves permanently removing the colon (a colectomy).

Once your colon is removed, your small intestine will be used to pass waste products out of your body instead of your colon.

This can be achieved by creating:

• an ileostomy – where the small intestine is diverted out of a hole made in your tummy; special bags are placed over this opening to collect waste materials after the operation
• an ileoanal pouch (also known as a J-pouch) – where part of the small intestine is used to create an internal pouch that’s then connected to your anus, allowing you to poo normally

As the colon is removed, ulcerative colitis cannot come back again after surgery.

But it’s important to consider the risks of surgery and the impact of having a permanent ileostomy or ileoanal pouch.

Your healthcare team will discuss the best option with you.

Find out more about ileostomies

Help and support

Living with a condition like ulcerative colitis, especially if your symptoms are severe, can be a frustrating and isolating experience.

Talking to others with the condition can provide support and comfort.

Crohn’s & Colitis UK provides information on where you can find help and support

Page last reviewed: 01 November 2022
Next review due: 01 November 2025

causes, symptoms, diagnosis and treatment

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Colitis: causes, symptoms, diagnosis and treatment.

Definition

Colitis is the general term for a group of disorders characterized by acute or chronic inflammation of the colonic mucosa.

Causes of colitis

Colitis can develop as a result of infection, insufficiency of blood supply to the intestine (ischemia), drug damage, is secondary to immunodeficiency conditions, can occur after radiation therapy of the pelvic organs in gynecological, urological and rectal cancer.

Inflammation of the colonic mucosa is characteristic of Crohn’s disease (CD) and ulcerative colitis (UC).

Microscopic colitis is also distinguished, in which the data of X-ray and endoscopic examinations of the intestine do not show abnormalities, and signs of inflammation are determined by biopsy.

Infectious lesions of the intestine can be caused by bacteria (most often Campylobacter jejuni ), viruses, protozoa and parasites. Infection with bacteria Campylobacter jejuni occurs as a result of eating dirty food or water. The development of colitis depends on the number of bacteria that have entered the intestines, their virulence (the ability to cause disease) and the person’s immunity. The incubation period is 2-4 days. Bacteria multiply in bile, and then penetrate through the mucous membrane into the intestine, causing severe inflammation.

Other bacterial pathogens are Salmonella, Shigella and Mycobacterium tuberculosis.

The reason for the development of infectious colitis in patients with weakened immunity, in patients with blood diseases, neoplasms, radiation sickness can be conditionally pathogenic microorganisms (representatives of normal intestinal microflora) – staphylococci, proteas, E. coli.

The toxin-producing anaerobic bacteria Clostridium difficile cause pseudomembranous colitis. The disease occurs against the background of changes in the normal intestinal microflora, mainly under the influence of antibiotics (cephalosporins, beta-lactam drugs), which inhibit the growth of other microorganisms and ensure the growth of Clostridium difficile .

Among the viruses that can cause colitis, cytomegalovirus is distinguished, among the protozoa – dysenteric amoeba ( Entamoeba histolytica ). Parasites whose vital activity results in colitis include pinworms, roundworms, whipworms, among those circulating in the blood are schistosomes.

Ischemic colitis occurs when there is insufficient blood supply to the large intestine, which leads to inflammation of the mucosa, the appearance of ulcers and hemorrhages.

The longer the interruption of blood supply, the more severely the intestines are affected. With the resumption of normal circulation, a reperfusion syndrome may occur, which leads to further severe damage to the intestine. Patients with ischemic colitis usually suffer from diseases of the cardiovascular system (heart failure, atherosclerosis, atrial fibrillation), may have malignant neoplasms and pathologies of the blood coagulation system leading to thrombosis. In addition, ischemic intestinal damage is determined during the so-called iatrogenic (medical care-related) interventions – operations to eliminate an aneurysm of the abdominal aorta, in preparation for colonoscopy or during its implementation.
Non-steroidal anti-inflammatory drugs, aspirin, proton pump inhibitors, beta-blockers, statins, immunosuppressive drugs can lead to drug-induced colitis.

The development of microscopic colitis is associated with autoimmune diseases such as celiac disease, type 1 diabetes mellitus, psoriasis, and thyroid dysfunction. There are two main subtypes of microscopic colitis – collagenous and lymphocytic.

UC and CD are classified as so-called inflammatory bowel diseases. The exact causes of the development of these diseases are unknown, however, it is likely that damage to the intestinal wall in UC is accompanied by an autoimmune reaction with the production of antibodies to the intestinal cells. Among the reasons for the development of CD, hereditary, infectious, immunological, etc. are discussed, but none of the theories is currently absolutely confirmed.

Classification of the disease

In addition to the etiological (causal) factor, colitis is divided depending on the severity of the process (acute and chronic) and severity. Chronic colitis is classified according to the nature of the course of the disease (continuous, recurrent, intermittent) and phases (exacerbation or remission). Depending on how the large intestine is affected in chronic colitis, typhlitis (inflammation of the caecum), transversitis (inflammation of the transverse colon), sigmoiditis (inflammation of the sigmoid colon), proctitis (inflammation of the rectum), angular colitis (left and right-sided depending on the affected bend of the transverse colon), and often they can be combined (proctosigmoiditis). With pancolitis, all parts of the large intestine are affected.

Symptoms of colitis

Acute colitis is accompanied by severe pain, patients report pain and cramps in the abdomen and rectum (tenesmus). Chronic inflammation is characterized by colic and a feeling of heaviness in the abdomen. Patients may experience constipation, watery diarrhea, sometimes with blood and mucus, turbulence in the abdomen, false urge to defecate, fatigue, fever.

In Crohn’s disease, rectal bleeding, abdominal pain, diarrhea, fever, anemia, lesions of the anal and perianal region with the formation of fistulas, ulcers, anal fissures are present. Often there are extraintestinal manifestations – arthritis, eye lesions, aphthous stomatitis, erythema nodosum – these lesions are noted in a third of patients with CD and are inextricably linked with intestinal inflammation.

The clinical picture of ulcerative colitis also includes pain, tenesmus, blood in the stool and diarrhea at night. As in CD, the development of UC is accompanied by extraintestinal lesions of the skin, oral cavity, joints, and organs of vision.

Colitis diagnostics

Diagnosis of colitis is based on clinical and laboratory data, endoscopy and biopsy.

First of all, it is necessary to conduct microbiological studies and cultures to rule out infection.

• Coprogram.

Koprogramma, Stool

There are restrictions on the days of taking samples in medical offices and receiving samples self-collected for this study (feces, urine, etc.).
We recommend that you check the details…

Up to 4 business days

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725 RUB

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Campylobacter spp. culture and antimicrobial susceptibility testing

The method of bacteriological examination of feces in order to detect and identify the causative agents of campylobacteriosis.

Campylobacter pylori (Campylobacter pylori) was discovered by Marsha. ..

Up to 5 business days

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RUB 1,490

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Culture for enteropathogenic Escherichia coli O157:H7 (E. coli O157:H7) and antimicrobial susceptibility test

Diagnosis of the etiology of hemorrhagic colitis and hemolytic uremic syndrome.

Escherichia coli (or simply E.coli) are gram-negative, rod-shaped bacteria. …

Up to 6 business days

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RUB 1,260

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Culture for pathogenic intestinal flora and determination of sensitivity to antimicrobial drugs

Determination of the etiology of ACID (acute intestinal infectious disease) and the choice of rational antibiotic therapy.

Rational therapy of dysentery is based …

Up to 6 business days

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1 200 RUB

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Fecal analysis for protozoa (PRO stool)

There are restrictions on the days of taking samples in medical offices and receiving samples self-collected for this study (feces, urine, etc.).
We recommend clarifying the in…

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RUB 570

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Fecal analysis for helminth eggs (helminth eggs)

There are restrictions on the days of taking samples in medical offices and receiving samples self-collected for this study (feces, urine, etc. ).
We recommend clarifying the in…

Up to 1 working day

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Clostridium difficile culture

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We recommend clarifying the in…

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In addition, the following tests are recommended:

• fecal occult blood test;

Fecal occult blood (colorectal bleeding), quantitative immunochemical Fecal Occult Blood Test FOB Gold

Synonyms: Fecal occult blood test.
Occult blood in feces (colorectal bleeding), quantitative immunoassay FOB Gold; FOB Gold Test.
Brief description of the study “Occult blood in the feces (colorectal cells)

Up to 3 business days

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840 RUB

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Anti-neutrophil cytoplasmic antibodies, ANCA Ig G (Anti-neutrophil cytoplasmic antibodies with indication of the type of luminescence – cytoplasmic or perinuclear, pANCA and cANCA, IgG)

Test used in the diagnosis of systemic vasculitis.

In the study of serum by indirect immunofluorescence using fixed…

Up to 9working days

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2 395 RUB

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To make a final diagnosis, endoscopic examination with biological material sampling (biopsy) is required:

• colonoscopy with sedation;

Colonoscopy with sedation (sleep)

Therapeutic and diagnostic method for examining the large intestine, during which, if necessary, minor surgical intervention (biopsy) can be performed. ..

RUB 10,790

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Gastroscopy with sedation (during sleep)

Diagnostic examination of the mucous membrane of the gastrointestinal tract.

RUB 8,740

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Rectosigmoscopy

Endoscopic examination of a section of the large intestine, which allows obtaining information about its condition and detecting various pathologies.

RUB 3,290

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Which doctors to contact

If you experience abdominal pain, stool disorders, symptoms of general intoxication, pallor of the skin and mucous membranes, weakness, you should contact

general practitioner

who will choose the scope of necessary examinations and treatment, as well as determine the need for consultation of narrow specialists:

gastroenterologist

,

oncologist

proctologist.

Treatment of colitis

Some infectious colitis require antibiotic therapy. Antibiotics are indicated for patients with dysentery and high fever, malignant neoplasms, AIDS patients, patients after transplantation, prosthetics, valvular heart disease and the elderly.

For mild to moderate cases of Clostridium difficile pseudomembranous colitis, metronidazole is the preferred treatment. In severe cases, vancomycin is recommended. In complicated cases – oral administration of vancomycin with intravenous administration of metronidazole.

Cytomegalovirus colitis is treated with valganciclovir; the duration of treatment is determined by the doctor depending on the clinical picture and laboratory parameters.

The goal of therapy for NUC and BK is to achieve and maintain remission, prevent complications, timely appointment of surgical treatment, and improve the quality of life of patients.

Treatment options for UC include medication, surgery, psychosocial support, and dietary advice. The basis of conservative therapy are preparations of 5-aminosalicylic acid, glucocorticoids, immunosuppressants, but a complete cure is achieved only through surgical intervention.

CD therapy is based on steroid hormones, salicylates, immunosuppressants and antibacterial drugs. Unlike NUC, in Crohn’s disease, surgical treatment, unfortunately, does not lead to a cure for patients, and its goal is to combat complications and improve the quality of life of patients when this cannot be achieved with medications.

Patients with ischemic bowel disease without signs of peritonitis (inflammation of the serous lining of the abdominal cavity) are indicated for drug treatment with replenishment of circulating blood volume and optimization of heart function, antibiotic therapy, oxygen support and intravenous nutrition to ensure peace of the intestine. In case of insufficiency of drug treatment and the development of peritoneal signs or intestinal perforation, bowel resection is required.

Complications

Complications of colitis include:

• perforation (through damage to the wall) of the intestine,
• strictures (narrowings) of the intestine, fistulas, abscesses and intestinal obstruction,
• fecal incontinence,
• skin fistulas, especially in Crohn’s disease,
• inflammatory complications after surgery for UC and CD,
• Guillain-Barré syndrome (for Campylobacter jejuni colitis, cytomegalovirus colitis and UC),
• hemolytic uremic syndrome (with enterohemorrhagic E. coli, with shigellosis),
• encephalopathy, convulsions (with shigellosis),
• Toxic megacolon is a rare complication of colitis characterized by total or segmental expansion of the large intestine, which is not associated with obstruction (obstruction), but is caused by systemic intoxication. The overall mortality rate for this complication reaches 19%. Ulcerative colitis and pseudomembranous colitis are complicated by toxic megacolon in more than 60% of cases.

Colitis prevention

As a preventive measure for inflammatory bowel diseases, general measures are recommended: compliance with sanitary and hygienic standards and the regime of work and rest, a healthy diet, timely preventive examinations and treatment of chronic diseases. Mironov I. L., Ratnikova L. I., Pirogov D. V., Milchenko I. B. Colitis associated with C. Difficile. Experimental and clinical gastroenterology, journal. Issue 111, No. 11, 2014. P. 65-69.

Clinical guidelines “Ulcerative colitis (adults). Developed by: Russian Gastroenterological Association, Russian Association of Coloproctologists. – 2020.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes over time, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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Ulcerative colitis (UC) – symptoms, causes, types, diagnosis and prevention and treatment methods in the “SM-Clinic”

This disease is treated by Gastroenterologist
, Proctologist

• What is it?
• About disease
• Types of ulcerative colitis
• Symptoms of ulcerative colitis
• Causes of ulcerative colitis
• Diagnosis of ulcerative colitis
• Expert opinion
• Treatment of ulcerative colitis
• Surgical treatment
• Prevention of ulcerative colitis
• Rehabilitation
• Q&A

About disease

Most often, UC occurs in the developed countries of Europe and North America. The prevalence of the disease in Russia is 20-30 cases per 100,000 population. Most often, the pathology occurs in men and women aged 20 to 42 years, as well as in the elderly.

Two most dangerous periods of development can be distinguished in ulcerative colitis:

• the first year; at this time, the likelihood of developing life-threatening complications is high;
• tenth year; at this point, the likelihood of developing malignant neoplasms increases.

Types of ulcerative colitis

The European consensus on the diagnosis and treatment of ulcerative colitis in 2006 identified 3 forms of the disease according to the degree of its prevalence:

• proctitis – an inflammatory process occurs only in the rectum and is limited by the rectosigmoid angle;
• left-sided colitis – inflammation reaches the splenic flexure of the colon;
• widespread colitis is a complete lesion of the large intestine.

Depending on the severity of the pathology, three degrees are distinguished:

• mild;
• medium;
• heavy.

Classification of ulcerative colitis according to the nature of development and course:

• acute: less than six months have passed since the first manifestation of the disease;
• fulminant (rapidly developing) course;
• chronic continuous course: with adequate treatment periods of remission are less than six months;
• chronic relapsing course: periods of remission last more than six months.

In the recurrent course of the disease, rarely recurrent (less than once a year) and often recurrent (2 times a year or more) are distinguished. Exacerbations of ulcerative colitis usually occur as a result of malnutrition, stress, or taking certain medications, but they can also occur without an obvious reason.

Symptoms of ulcerative colitis

Nonspecific ulcerative colitis is characterized by a cyclic course: periods of remission alternate with exacerbations. During remissions, there are usually no signs of UC, while exacerbations are characterized by various manifestations that vary depending on the location of inflammation and the intensity of the course of the disease.

The main symptoms of proctitis are:

• pain in the lower abdomen;
• bloody discharge from the anus;
• painful urge to empty the bowels.

Signs of left-sided ulcerative colitis with damage to the descending colon are:

• diarrhea with bloody impurities;
• weight loss;
• pronounced pain in the left side of the abdomen.

Widespread ulcerative colitis with total involvement of the large intestine is characterized by:

• persistent abdominal pain;
• persistent profuse diarrhea with bleeding.

In the latter case, the patient’s life is threatened by severe dehydration and blood loss.

It is also noted that sometimes people with ulcerative colitis may experience non-intestinal symptoms:

• stomatitis;
• vascular inflammation;
• diseases of the joints;
• dermatological pathologies;
• diseases of the biliary tract;
• bone softening or osteoporosis;
• ocular inflammatory diseases.

Causes of ulcerative colitis

At the moment, the causes of the disease remain unclear. It is statistically determined that ulcerative colitis of the intestine is more often diagnosed in people whose relatives had this pathology, and therefore the main cause is considered to be a genetic predisposition. The key to the development of ulcerative colitis is thought to be an imbalance in the immune system. A pathogenic microorganism provokes an immune response, due to which an inflammatory process develops that affects the intestinal mucosa and leads to ulcers and erosions.

There are several main factors in the development of ulcerative colitis:

• prolonged use of antibiotics;
• viral and bacterial infections;
• hereditary predisposition;
• congenital and acquired defects of immunity.

Get advice

If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health.

You can find out more about the disease, prices for treatment and sign up for a consultation with a specialist by calling:

+7 (495) 292-39-72

Request a call back
Book online

Why SM-Clinic?

1

Treatment is carried out in accordance with clinical guidelines

2

Comprehensive assessment of the nature of the disease and treatment prognosis

3

Modern diagnostic equipment and own laboratory

4

High level of service and balanced pricing policy

Diagnosis of ulcerative colitis

The proctologist is engaged in the diagnosis and treatment of pathology. First of all, the specialist collects complaints and anamnesis, and then examines the patient, including a digital examination of the rectum.

For further research and differentiation from Crohn’s disease and other diseases of this type, a comprehensive diagnostic examination of the patient is required. The main most important procedures are colonoscopy with intestinal biopsy and sigmoidoscopy. These methods allow you to visually assess the condition of the colon mucosa.

To clarify the presence of edema, perforations, ulcers and other formations (inflammatory polyps, thickenings, and so on), an X-ray examination may be prescribed.

In addition to instrumental methods, laboratory diagnostics are performed:

• total fecal analysis;
• complete blood count to detect leukocytosis and anemia;
• fecal analysis to determine the severity of the inflammation process;
• biochemical blood test to exclude concomitant pathologies;
• Examine feces for Clostridial toxins A and B to rule out clostridial intestinal infection.

Expert opinion

Ulcerative colitis is a dangerous disease that, if left untreated, can cause severe life-threatening consequences. At the same time, there is a high probability that urgent surgical intervention will be required to eliminate them. Complications of NUC can affect not only the intestines, but also many other vital organs.

Timely medical diagnosis makes it possible to detect the disease even in the remission phase and take it under control. At the same time, the quality of life of the patient will improve significantly, and exacerbations will occur much less frequently. With ulcerative colitis, it is extremely important to diagnose the disease before severe complications appear: persistent diarrhea, bleeding, etc. This will avoid surgical intervention and confine itself to conservative therapy.

Matyukhin Anatoly Andreevich

Gastroenterologist, hepatologist, PhD

Treatment of ulcerative colitis

Tactics of therapy are selected depending on the degree of intestinal damage and the severity of the course of the disease. If only the rectum is affected, outpatient treatment is sufficient in most cases. With left-sided and widespread colitis, hospitalization is necessary.

Treatment for ulcerative colitis includes diet, drug therapy, and, if necessary, surgery.

Conservative treatment

The main goal of drug therapy is to relieve the symptoms of the disease and stop the development of inflammation and ulceration.

In ulcerative colitis, a doctor prescribes several groups of drugs:

• painkillers;
• antidiarrheals;
• immunosuppressants;
• iron preparations for anemia;
• non-steroidal and hormonal anti-inflammatory drugs.

Diet plays an important role in the therapy process. The patient is forbidden to eat foods rich in fiber, as well as fried, fatty, spicy, salty and sour foods. At the same time, it is recommended to eat more protein foods.

During a severe flare-up, a complete refusal to eat may be recommended in order to ease bowel movements. In this case, nutrients are injected into the body intravenously.

Surgery

If conservative treatment fails, surgeons excise the affected part of the colon. After that, a reservoir is formed from the area of ​​the small intestine, which takes over the functions of the remote department. With a small lesion, the use of a graft is not necessary.

Prevention of ulcerative colitis

Since the causes of ulcerative colitis are not fully understood, the main preventive measure is to maintain a healthy lifestyle:

• minimization of stressful situations;
• maintaining proper diet;
• smoking cessation and alcohol abuse;
• maintaining moderate physical activity.

Rehabilitation

After the operation, the patient can return to normal life in 2-3 weeks. In the presence of severe complications, full recovery of capacity can take up to four months. After discharge from the hospital, the patient must comply with all the instructions of the attending physician and register with the dispensary. Until the tissues heal, it is necessary to limit physical activity, carrying weights, thermal procedures, and insolation. In order to maintain a normal state of health, it is recommended to undergo annual spa treatment. The diet is for life.

Question-answer

In the absence of treatment against the background of UC, severe complications may develop, these include:

• toxic dilatation (expansion) of the large intestine;
• profuse intestinal bleeding;
• perforation of the colon wall;
• stricture (narrowing) of the intestine;
• colorectal cancer.

Ulcerative colitis does not go away on its own. Delay in seeking medical help can lead to life-threatening complications.

Ishutina IN Therapeutic aspects of nonspecific ulcerative colitis // BMIK. 2015. No. 5.

Andreeva NA X-ray examination in nonspecific ulcerative colitis // BMIK. 2014. No. 11.

Stepanov Yu.M., Psareva I.V. Clinical and endoscopic parallels in nonspecific ulcerative colitis // Gastroenterology. 2019. №3.

Tikhonova TA Objective and subjective approaches in the management of patients with bowel diseases // BMIK. 2014. No. 5.

Tazhibaeva F.R., Mamasaidov A.T., Zhalalova G.T. New aspects of the treatment of nonspecific ulcerative colitis // Territory of Science. 2016. No. 1.

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Diseases referred to Gastroenterologist

Avitaminosis
Ascariasis
Atrophic gastritis
Achalasia
Balantidiasis
Crohn’s disease
Viral hepatitis
Gastritis
gastroptosis
Gastroenteritis
Gastroenterocolitis
Helminthiasis
Liver hemangioma
Hepatitis A
Hepatitis B
Hepatitis D
Hepatitis E
Hepatitis C
Hepatomegaly
hiatal hernia
Diarrhea
diarrhea during pregnancy
Traveler’s diarrhea
Intestinal diverticulosis
Dysbacteriosis
Dyspepsia
Benign neoplasms of the esophagus
Duodenitis
Jaundice
Cholelithiasis
fatty liver disease
Fatty hepatosis
Constipation
Heartburn
intestinal candidiasis
liver cyst
pancreatic cyst
intestinal colic
Colitis
Blood in stool
Flatulence
Mechanical jaundice
food poisoning
pancreatitis
Intestinal pneumatosis
Polyps of the stomach
Gallbladder polyps
Intestinal polyps
Postcholecystectomy syndrome
Reflux esophagitis (GERD)
Gilbert’s syndrome
Spasm of the esophagus
Toxic hepatitis
Helicobacteriosis
Cholangitis
cholestasis
Cholecystitis
Chronic gastritis
Chronic cholecystitis
celiac disease
Cirrhosis of the liver
Enteritis
Enterocolitis
Erosive gastritis
Esophageal ulcer
Peptic ulcer of the stomach and duodenum

Diseases referred to Proctologist

Anal fissure
anal fringes
Crohn’s disease
Pain in the anus
rectal prolapse
Haemorrhoids
Constipation
warts
coccygeal passage
Blood in stool
paraproctitis
Proctitis
Rectovaginal fistula
Fistula of the rectum
Chronic pelvic pain syndrome
Encoprese

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Voikovskaya metro station

Staropetrovsky proezd, 7A, building 22

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