Ulcerative colitis is a chronic condition in which the colon (large intestine) becomes inflamed with ulcers, resulting in diarrhea and bleeding. Ulcerative colitis tends to affect the lower part of the colon and the rectum, but can affect the entire colon.
Crohn’s disease is another type of IBD, but unlike ulcerative colitis that only affects the colon, Crohn's disease can affect any part of the gastrointestinal tract from the mouth to the anus.
When the disease is managed, people with ulcerative colitis usually have the same life expectancy as people who do not have ulcerative colitis.
However, while ulcerative colitis usually isn’t fatal in itself, some of the complications of the condition may be. Possible complications of ulcerative colitis include:
- Osteoporosis, usually a result of side effects of prolonged steroid use
- Poor growth and development and delayed puberty in children
- Colorectal cancer
- Blood clots
- Gastrointestinal perforation
- Severe bleeding
- Progressive inflammation and damage of bile ducts (primary sclerosing cholangitis) (rare)
- Toxic megacolon (rare)
What Are Symptoms of Ulcerative Colitis?
Symptoms of ulcerative colitis vary and about 50% of patients experience mild symptoms, including:
- Persistent diarrhea (may be bloody)
- Rectal bleeding
- Urgent bowel movements
- Painful urge to move the bowels caused by the inflammation
- Abdominal cramps and pain
- Rectal pain
- Fatigue
- Weight loss
- Night sweats
- Fever
- Dehydration
Relapses when inflammation and symptoms worsen (flares) usually occur, followed by periods of remission that last months to years when symptoms subside.
What Is the Treatment for Ulcerative Colitis?
Medications are the main treatment for ulcerative colitis. The goal of treatment is to induce or maintain remissions and improve quality of life. Patients who have severe inflammation and life-threatening complications may need surgery as a last resort.
Medications used to treat ulcerative colitis include:
- Anti-inflammatory drugs
- 5-ASA compounds
- Balsalazide (Colazal)
- Mesalamine (Apriso, Asacol, Lialda. Pentasa, Rowasa)
- Olsalazine (Dipentum)
- Systemic corticosteroids (prednisone, cortisone, prednisolone)
- Topical corticosteroids
- 5-ASA compounds
- Immunomodulators
- Azathioprine/6-MP (Azasan, Imuran)
- Cyclosporine (Neoral, Sandimmune)
- Methotrexate (Otrexup, Trexall)
- Tacrolimus (Prograf)
- Biologic therapies
- Adalimumab (Humira)
- Golimumab (Enbrel)
- Infliximab (Remicade)
- Vedolizumab (Entyvio)
- Janus kinase inhibitors (JAK Inhibitors)
- Tofacitinib (Xeljanz)
Surgery for ulcerative colitis is used as a last-resort for severe cases. Surgery involves removal of the entire colon and the rectum, which is the only permanent cure for ulcerative colitis.
From
https://pubmed.ncbi.nlm.nih.gov/8613037/
https://www.crohnscolitisfoundation.org/
https://www.cmaj.ca/content/192/45/E1394
https://pubmed.ncbi.nlm.nih.gov/14724807/
https://www.nhs.uk/conditions/ulcerative-colitis/complications/