What is ulcerative colitis?
Ulcerative colitis is a disease that causes inflammation (swelling and pain) of the lining of the colon (large intestine) or rectum.
Ulcerative colitis can be divided into several types, depending on which area of the rectum and colon it affects (find out more about the digestive system here).
| INFLAMED AREA: | MEDICAL NAME: |
|---|---|
| Rectum | Proctitis or ulcerative proctitis |
| Rectum and lower end of colon | Proctosigmoiditis |
| Whole part of the colon on the left side of the abdomen | Distal ulcerative colitis or just distal colitis
|
| Affecting more than the left colon, usually the entire colon | Pancolitis |
| Affects the entire colon and causes severe pain, profuse diarrhea and, sometimes, dehydration and shock. This is a rare and life-threatening form of colitis | Fulminant colitis |
Who gets ulcerative colitis?
| Europe | 0.6 to 24.3 per 100,000 people |
| Asia and Middle East | 0.1 to 6.3 per 100,000 people |
| North America | 0 to 19.2 per 100,000 people |
| Ages | Can develop at any age, but most commonly starts between the ages of 30 and 40 |
| Males or females | Women and men equally |
Symptoms
The most common symptoms are:
- Abdominal pain – This can be crampy, usually on the left side (as the colon runs along the left side of your body)
- Diarrhoea – As the intestinal lining becomes more inflamed and ulcerated, it loses its ability to absorb water from the waste material that passes through the colon leading to diarrhoea
- Blood or mucus stools – The damaged, ulcerated intestinal lining can also produce a lot of mucus and blood, which are deposited into the stools
Other symptoms depend on whether you have a mild, moderate or severe form of the disease.
| MILD | MODERATE | SEVERE | |
|---|---|---|---|
| Blood in the stools | Present | Present | Present with a lot of pus (material). Bloated stomach, air in the intestines. Fever and generally feeling unwell |
| Stool type | Grainy | Watery | Diarrhoea |
| Bowel movements | A few times a day | Frequent | Very frequent. Constant defacation urge |
| Urgency to defacate | Present | Present | Present |
| Other symptoms | Urge to go to the toilet when no stool is present (tenesmus). May feel tired or listless | Urge to go to the toilet when no stool is present (tenesmus). Fever, loss of weight, persistent abdominal pain (especially on the left side), bloatedness, fatigue |
Eventually, blood loss may lead to tenesmus. Diarrhoea and abdominal pain can make you lose your appetite and lose weight. These symptoms also can produce fatigue, which is a side effect of anaemia as well.
With treatment, the symptoms recede gradually over a period of weeks or months. People with ulcerative colitis may also experience constipation, which can result in bouts of abdominal pain and bloatedness.
Children with ulcerative colitis may fail to develop or grow properly. With treatment, the symptoms recede gradually over a period of weeks to months. If you have ulcerative colitis, you may also experience bouts of constipation in between.
Always contact your medical specialist immediately if you have:
- Pain, ulcers or tender swelling in the rectum
- If you experience an acute (sudden) worsening of complications
- If your stomach area is very bloated, or if you have abdominal pains, vomiting or constipation you may have an intestinal obstruction.
References
1: Molodecky, N.A., Soon, I.S., Rabi, D.M., Ghali, W.A., Ferris, M., Chernoff, G., Benchimol, E.I., Panaccione, R., Ghosh, S., Barkema, H.W., et al. (2012). Increasing Incidence and Prevalence of the Inflammatory Bowel Diseases With Time, Based on Systematic Review. Gastroenterology 142, 46–54.e42.
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