What Are Ulcerative Colitis Symptoms
Ulcerative colitis is an inflammatory bowel disease that can be life-threatening when the symptoms flare up. Its important for you to go to the hospital for treatment when your symptoms are too severe.
The condition doesnt have a cure, but it can have periods where the symptoms become extreme and flare-up or where they go into remission.
At least 25% of all cases of ulcerative colitis lead to hospitalization. You may need to be hospitalized many times throughout your life for this condition, particularly during flare-ups.
The main way to manage the disease is by taking an oral corticosteroid, typically in the form of a daily pill. You need to seek medical attentionand will likely be hospitalizedwhenever your body isnt responding to this treatment.
This leads to many different symptoms, including:
Over long periods of time, ulcerative colitis can lead to further complications, including:
When Are Your Symptoms Severe Enough For Hospitalization?
Youll experience your ulcerative colitis symptoms on and off throughout your life. You should always contact your doctor when you have concerns about your symptoms or if new ones develop.
You should seek inpatient treatment at a hospital whenever:
Fatigue In Children With Ulcerative Colitis
In a 2019 study , researchers looked at how children with ulcerative colitis experienced fatigue.
They found that, like adults, children with the condition can experience high levels of fatigue. They noted the following potential reasons for this:
- disease activity level
According to the Crohns and Colitis Foundation, fatigue is a common issue among people with IBD. It affects 80% of people with active IBD and 50% of people in clinical remission.
Despite the frequency of fatigue in IBD, researchers have indicated that it is often underreported and undertreated. They have noted that doctors often do not treat fatigue because of the subjective nature of the condition.
People with fatigue should talk with a doctor and make sure that they understand how much fatigue affects their life. The more information a person can provide about their symptoms, the more likely the doctor is to understand fatigue as a serious symptom and make recommendations for treatment.
In addition to taking steps to manage and treat ulcerative colitis, a person can make certain lifestyle changes to help reduce fatigue.
Some potential ways for a person to improve fatigue and boost energy levels include:
In one 2020 study , researchers found that the best way to treat fatigue is to treat its underlying causes.
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Oral Vs Rectal Treatments
Most physicians prescribe ulcerative colitis patients oral versions of 5-ASAs or corticosteroids, since this is a patient-preferred delivery method of medication. However, even if they have a specially designed release mechanism, they might not reach and treat the area where the disease is most active.
For example, when you apply sunscreen to your skin, you need to make sure that you cover every exposed part to protect it from the sun. Similarly, when applying these treatments to your rectum and lower colon, you need to make sure that the product covers all of the inflamed areas.
Oral tablets might not be the optimal way to reach the end of the colon, where stool and the fact that ulcerative colitis patients have diarrhea, might interfere with its effectiveness. Unfortunately, this is also the area in the colon where a flare usually starts. The best way to reach this particular area is by inserting the drug directly into the rectum.
The medication released from a suppository will travel upward and usually reach about 15 cm inside from the anus. An enema will reach farther, about 60 cm. Those with ulcerative colitis usually insert these formulations before bedtime, and this way the medication is retained as long as possible. Stool does not typically interfere with the drug, since the bowel area is typically relatively empty right before bed.
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What Should I Ask My Doctor On Behalf Of My Child Or Teenager
Ask your healthcare provider the following questions in addition to the ones listed above:
- What vitamins should my child take?
- Will my other children have pediatric ulcerative colitis?
- Is my child at risk for other conditions?
- Can you recommend a psychiatrist or therapist to help my child with emotional issues related to pediatric ulcerative colitis?
- Is my child growing at a normal rate?
- What can I do to help my child cope at school?
A note from Cleveland Clinic
When you have ulcerative colitis, its essential to work closely with your healthcare team.
Take your medications as prescribed, even when you dont have symptoms. Skipping medications youre supposed to take can lead to flareups and make the disease harder to control. Your best shot at managing ulcerative colitis is to follow your treatment plan and talk to your healthcare provider regularly.
What Exams And Tests Diagnose Colitis
While unpleasant, the rectal examination is very important. Using a finger, the doctor feels inside the rectum, exploring for any masses or tumors. The color and consistency of stool can be evaluated, and if it is not grossly bloody, can be tested for occult blood .
The history will assist the health-care professional decide the tests to order and what cultures would be appropriate. Blood tests help assess the stability of the patient, and also explore any potential issues associated with colitis.
- A complete blood count will assess the red blood cell count, the white blood cell count, and the number of platelets.
- The red blood cell count will help define the amount of bleeding.
- White blood cell counts elevate when the body is undergoing physical , physiological, or emotional stress.
- Platelets help blood to clot, so knowing the platelet number in a patient with bleeding may be useful.
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Ulcerative Colitis And Colorectal Cancer
Ulcerative colitis increases the risk of colorectal cancer. Colorectal cancer often begins as small growths on the inside of the large intestine. The risk of colorectal cancer increases based on:
- the length of time a person has had ulcerative colitis
- how much of the colon is affected by ulcerative colitis
People with ulcerative colitis should have more frequent tests for polyps and colorectal cancer than people at average risk. The gold standard screening test is a colonoscopy. Polyps can be removed during a colonoscopy. This reduces the risk of colorectal cancer. Ask your doctor how often you should be checked for colorectal cancer.
Surgery to remove the entire colon eliminates the risk of colon cancer.
Why Choose Mount Sinai
Mount Sinai has a unique and rich tradition of specialized and individualized treatment and scientific research and discovery in ulcerative colitis. The physicians/scientists in the Mount Sinai Health System are constantly conducting clinical trials and are developing new drug therapies to help patients manage their disease. Learn more about ulcerative colitis.
There are 3 basic tests for colon cancer a stool test , sigmoidoscopy , and colonoscopy . All 3 are effective in catching cancers in the early stages, when treatment is most beneficial.
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Ulcerative colitis is categorized according to location. Proctitis involves only the rectum. Proctosigmoiditis affects the rectum and sigmoid colon. Left-sided colitis encompasses the entire left side of the large intestine. Pancolitis inflames the entire colon.
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Symptoms Of A Duodenal Ulcer
If you have a duodenal ulcer, you might:
- have pain in the stomach or abdomen
- have indigestion
Very occasionally, an ulcer can cause serious complications. Go to the emergency department if:
- you have a sharp pain in your stomach that doesnt go away
- your vomit or stools look bloody or a black colour
If you are concerned about symptoms, you can use healthdirects online Symptom Checker to get advice on the next appropriate healthcare steps and when to seek medical attention.
Living With Uc: Diet Changes
Although it has not been found that diet has an effect on ulcerative colitis, it generally is recommended that patients eliminate any foods that they find are making their symptoms worse. For example, milk in people with UC who are intolerant to the sugar in milk, lactose, may be causing gastrointestinal symptoms such as abdominal bloating, flatulence, and diarrhea, symptoms that may overlap with those of ulcerative colitis. Despite not being the cause of the ulcerative colitis, eliminating milk may improve gastrointestinal symptoms in these people. It is important to be sure that the diet is nutritionally adequate, and this may require the assistance of a dietician.
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What To Expect After Your Surgery
Most people do very well after their surgery and are able to return to work and their normal daily activities after they recover.
You should expect an adjustment period of up to one year to get used to the changes in your body after your proctocolectomy.
You will likely be on liquid or soft food diet for the first few days after surgery. Your doctor will then have you slowly introduce bland solid foods. You should chew your food thoroughly and avoid any foods that may cause gas, diarrhea or anal irritation. Its also important to drink plenty of water. We recommend six to eight glasses a day.
Some patients may still feel as if they need to have a bowel movement after their surgery, just as people who have lost a limb sometimes still feel as if the limb is still there. This called phantomrectum and it completely normal. It does not require any treatment and often subsides over time.
Your doctor may recommend a physical activity restriction for a minimum of six weeks, depending on what type of surgery you had.
Talk to your doctor about resuming normal sexual activity after your surgery. Some people find their sex life improves some time after surgery due to improvements in pain, inflammation, and other ulcerative colitis symptoms.
What Questions Will The Doctor Ask Me About My Colitis
The health-care professional will perform a physical examination on the patient by taking vital signs, and focusing on the abdomen feeling for areas of tenderness, for masses, or abnormally enlarged organs.
The health-care professional also will take a past medical history to assess the risk factors for peripheral vascular disease , for example, smoking, high blood pressure, high cholesterol, and diabetes. These risk factors are important in exploring ischemic bowel as the cause for colitis.
The health-care professional may ask the patient the following questions:
- When and what time did the symptoms start?
- How long does the pain last?
- How frequent is the diarrhea?
- Are any other associated symptoms or signs?
- Has the patient traveled recently, been on an unusual diet, or has used or drank noncommercial water This may assist in the diagnosis to bacterial infections such as Shigella, Campylobacter, or Yersinia or parasite infections such as giardia.
- Has the patient recently used antibiotics? Recent use of antibiotics may direct the health-care professional to consider Clostridium difficile as the cause.
- Has there been any blood in the stool?
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Research And Statistics: How Many People Have Ulcerative Colitis
People of European descent have a higher risk of developing ulcerative colitis than do those of African or Hispanic descent.
People of European Jewish descent have an especially high risk.
Ulcerative colitis tends to run in families, affecting men and women equally overall. But older men are more likely to develop it than older women, according to the Crohns and Colitis Foundation.
What Are The Most Common Ulcerative Colitis Symptoms
Early ulcerative colitis symptoms usually include things that could easily be overlooked. Dont be afraid to talk to a doctor if youre having any worries though, even if your symptoms seem mild. If symptoms are ongoing and start to feel more severe, like persistent pain in your abdomen or unintentional weight loss, you should seek medical treatment as soon as possible.
Here are some of the most common symptoms of ulcerative colitis to watch out for, per the NIDDK:
Okay, so this isnt the most pleasant one to start with, but it is actually the most common ulcerative colitis symptomits also a pretty good tip-off that something isnt quite right and that you should schedule an appointment with your doctor. Remember those ulcers we talked about earlier? Yeah, thats where the blood in your stool comes from, and you might also see mucus in there as well.
This is another pretty common symptom, and contrary to popular belief, those ulcers in the colon are not actually what causes the pain. Instead, its a combination of abdominal cramping and bowel distension that occurs due to the inflammation in the intestines, according to a 2013 study published in Inflammatory Bowel Diseases.1
With all thats going on in the digestive tract with ulcerative colitis, nausea can sometimes be an issue. This occurs more often when symptoms are severe, or if the inflammation affects more of the large intestine, according to the NIDDK.
Daily Life For People With Ibd
People with IBD lead useful and productive lives, even though they need to take medications. When they are not experiencing a flare-up of their disease, they feel quite well and are often free of symptoms.People with IBD can marry, enjoy sexual activity and have children. They can hold down jobs, care for families and enjoy sport and recreational activities.Even though there is currently no cure for IBD, medical therapy has improved the health and quality of life of most people with Crohns disease and ulcerative colitis. Research underway today may lead to further improvements in medical and surgical treatment, and even a cure.
Ulcerative Colitis In Children
According to one study of IBD in the United States, 1 in 1,299 children between ages 2 and 17 years old were affected by the condition in 2016. Crohns disease was twice as common as UC, and boys were more likely to have IBD than girls.
For children with IBD, a diagnosis is more likely after 10 years old.
UC symptoms in children are similar to symptoms in older individuals. Children may experience bloody diarrhea, abdominal pain and cramping, and fatigue.
In addition, they may experience issues compounded by the condition, such as:
- anemia due to blood loss
- malnutrition from poor eating
- unexplained weight loss
UC can have a significant effect on a childs life, especially if the condition isnt treated and managed properly. Treatments for children are more limited because of possible complications. For example, medicated enemas are rarely used as a treatment method in children.
However, children with UC may be prescribed medications that reduce inflammation and prevent immune system attacks on the colon. For some children, surgery may be necessary to manage symptoms.
If your child has been diagnosed with UC, its important that you work closely with their doctor to find treatments and lifestyle changes that can help. Check out these tips for parents and children dealing with UC.
How Do You Get An Ulcerative Colitis Diagnosis
One important thing to note is that people with more severe cases of ulcerative colitis are at an increased risk of developing colon cancer and other serious health conditions, like liver disease, Rudolph Bedford, M.D., a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. Thats why its important to reach out to a medical professional if you do have any of the above symptoms.
However, an ulcerative colitis diagnosis can be challenging because other conditions can mimic symptoms of IBD, like infections or even hemorrhoids, Dr. Sinha says. In terms of differentiating between Crohns and ulcerative colitis, he says, Theres no single test that we have that 100% distinguishes between the two. We rely on the patient history and other information such as radiographic imaging and endoscopy. Doing a colonoscopy, for example, can be one of the most reliable ways to identify IBD and to then distinguish between Crohns and ulcerative colitis.
While a colonoscopy is an effective tool, Dr. Sinha clarifies that its not the only way. Rather, theres an entire constellation of tests and data that can be considered, including imaging, lab tests, and a detailed intake of the patients symptoms and presentation.
Is There An Ulcerative Diet Listing Foods To Avoid And Foods That Relieve Symptoms
Proper nutrition is important for a person with ulcerative colitis. Foods do not cause ulcerative colitis, but certain food groups can cause symptoms to flare. Often it is a process of trial and error to find what foods need to be avoided. Although specific foods do not cause the disease, some types of food may trigger discomfort and diarrhea. Keep a food diary to help find foods that cause problems.
Counseling and education are important for both the patient and family a better understanding of how ulcerative colitis affects the body will allow the patient and physician to work together to control the symptoms.
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