Overview

Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that causes inflammation and ulcers in the inner lining of the large intestine. It usually affects the rectum and may extend to other parts of the colon. The condition can cause diarrhoea, abdominal pain, rectal bleeding and an urgent need to pass stools.

At Sarvodaya Hospital, patients seeking ulcerative colitis treatment can consult a qualified gastroenterologist for assessment and an individualised management plan, subject to the services available at the treating location. Treatment may include medication, biologic therapies, dietary guidance, regular monitoring and surgery when necessary.

Symptoms of Ulcerative Colitis

• Frequent, loose stools that may contain blood or mucus.
• Blood may appear in the stool or during bowel movements.
• Pain may occur alongside an urgent need to pass stools.
• A sudden, difficult-to-control need to use the toilet.
• A persistent feeling that you need to pass stools even when the bowel is empty.
• Ongoing inflammation, poor sleep or anaemia may contribute to tiredness.
• Active disease may affect appetite and nutritional health.
• This may occur during more severe inflammation or complications.

Causes of Ulcerative Colitis

• Immune System Activity
• Genetic Factors
• Environmental and Biological Factors

●       Changes in Gut Microbiome

●       Intestinal Barrier Function

• Immune Regulation and Inflammation

Diagnosis of Ulcerative Colitis

Ulcerative colitis diagnosis involves reviewing symptoms, medical history, examination findings and investigations. The aim is to confirm intestinal inflammation, determine how much of the colon is affected and rule out other conditions, including intestinal infections.

• Blood Tests : Blood tests may help identify anaemia, inflammation, dehydration and other abnormalities. Depending on the patient's condition, tests may include a complete blood count, C-reactive protein (CRP), electrolyte levels and other relevant markers.
• Stool Tests: Stool tests can help detect intestinal inflammation and rule out infections that may cause similar symptoms. Faecal calprotectin, a marker of intestinal inflammation, may also help assess disease activity.
• Colonoscopy and Biopsy: Colonoscopy allows a specialist to examine the lining of the rectum and colon using a flexible tube with a camera. During the procedure, small tissue samples may be collected for examination under a microscope.
• Imaging Tests: Imaging, such as abdominal X-rays or CT scans, may be required if severe inflammation or complications are suspected.

Benefits of Timely Ulcerative Colitis Treatment

• Treatment can reduce diarrhoea, abdominal pain, rectal bleeding and bowel urgency.
• Appropriate medication may help achieve periods when symptoms are minimal or absent.
• Monitoring and treatment can help identify anaemia, dehydration, severe inflammation and other complications.
• Managing active disease can help improve appetite and reduce the effects of ongoing intestinal symptoms.
• Regular reviews allow the treatment plan to be adjusted according to symptoms, test results and treatment response.

Complications if Ulcerative Colitis is Not Controlled

• Ongoing intestinal bleeding and inflammation can reduce red blood cell levels.
• Persistent diarrhoea can cause fluid and electrolyte loss.
• Reduced food intake or ongoing illness may affect nutritional health.
• A serious flare-up may require hospital treatment.
• Severe inflammation can cause the colon to become dangerously enlarged.
• Severe disease can rarely lead to a hole in the bowel wall.
• Long-standing inflammation affecting the colon can increase risk, making appropriate surveillance important.
• Some people develop problems involving the joints, eyes, skin, liver or bile ducts.

Prevention and Lifestyle Modifications

• Follow the prescribed treatment plan: Continue maintenance medication as advised, even when symptoms improve.
• Maintain a balanced diet: Choose foods that provide adequate energy, protein, vitamins and minerals.
• Identify personal food triggers: Keep a food and symptom record if particular foods appear to worsen symptoms.
• Stay hydrated: Replace fluids lost through diarrhoea and follow medical advice during severe flare-ups.
• Avoid unnecessary dietary restrictions: Excluding entire food groups without guidance may lead to nutritional deficiencies.
• Attend follow-up appointments: Regular reviews help assess disease activity and treatment response.
• Manage stress: Relaxation, adequate sleep and appropriate support may help with coping, although stress is not the sole cause of ulcerative colitis.
• Discuss pain medicines with your doctor: Some medicines, including non-steroidal anti-inflammatory drugs (NSAIDs), may worsen symptoms in some people.

When Should You See a Doctor?

• Consult a gastroenterologist for persistent diarrhoea, blood in stools or abdominal cramps.
• Seek medical advice for bowel urgency or unexplained weight loss.
• Contact your doctor if ulcerative colitis symptoms worsen or bleeding increases.
• Seek medical review if your prescribed treatment no longer controls your symptoms.
• Seek urgent medical care for severe abdominal pain, heavy rectal bleeding, fever with worsening symptoms, repeated vomiting, faintness or signs of significant dehydration.

Pre- and Post-Treatment Care

Pre-Treatment

• Review symptoms, medical history and previous treatments.
• Arrange blood and stool tests to assess inflammation and exclude infection.
• Review colonoscopy and biopsy findings.
• Assess nutritional status and signs of anaemia or dehydration.
• Explain the expected benefits, risks and monitoring requirements of the proposed treatment.
• Arrange infection screening and vaccination review before selected immunosuppressive or biologic therapies.

Post-Treatment

• Reviewing bowel symptoms and treatment response.
• Repeating blood and stool tests when indicated.
• Adjusting medicines under medical supervision.
• Monitoring for treatment-related side effects.
• Reviewing diet, hydration and nutritional needs.
• Attending colonoscopy appointments for disease assessment and colorectal cancer surveillance when recommended.