Ulcerative Colitis (UC) Symptoms, Signs, Causes, And Treatments

Below, you’ll find must-know information about ulcerative colitis (UC).

Ulcerative colitis (UC) is a chronic inflammatory bowel disease that affects the large intestine (colon) and the rectum. Also known as inflammatory bowel disease or IBD, this health condition affects any age group.

Ulcerative colitis is considered an autoimmune disorder. (1)  The immune system targets healthy tissue, damaging it by mistake.

The immune system releases white blood cells into the bloodstream to combat infections. Hence it adds a protective layer by getting rid of the problem. With the onset of ulcerative colitis, the good bacteria in the colon are attacked. This results in inflammation in affected areas.

Aside from immune factors, genetics, and environmental factors also play an important role in the development of ulcerative colitis.

The condition often runs in families. Specific genes have been identified and associated with the risk of developing the disease. (2)

Furthermore, high consumption of refined sugar or saturated fat may also increase the risk of developing the condition. Stress has also been shown to trigger symptoms in some people with this particular type of health condition.

While ulcerative colitis is not a serious disease it can be for some folks. If it’s ignored, let alone, untreated, it can get worse and threaten the life of the individual.

Ulcerative colitis can also lead to complications such as colon cancer, blood clots, and severe inflammation in other parts of the body, such as the eyes and joints.

Knowing the various ulcerative colitis symptoms can help prevent the condition from getting worse.

Below are ulcerative colitis symptoms worth knowing about.

12. Diarrhea

This is one of the most common symptoms of ulcerative colitis. The stool may be loose, watery, or may contain blood or mucus. This is usually caused by inflammation of the lining of the large intestine and rectum.

The inflammation causes the intestine to produce more mucus, which makes the stool more watery and loose. The inflammation can also cause the intestine to absorb less water and nutrients from the food, which can worsen diarrhea.

This inefficient absorption can also lead to malnutrition, as the body is not obtaining the nutrients it needs from the food being consumed. Over time, this can lead to weight loss, fatigue, and other complications.

11. Abdominal Pain And Cramping

The inflammation in the large intestine can also cause pain and discomfort in the abdomen. The inflammation causes the intestine to become swollen and irritated, which leads to pain and discomfort.

As a result of the inflammation, spasms in the muscles of the intestine can also cause abdominal pain and cramping. In some cases, the pain and cramping may be severe and can interfere with daily activities.

10. Rectal Bleeding

This is a common symptom of ulcerative colitis. Blood may appear in the stool or on the toilet paper after wiping. This is caused by the development of small ulcers in the lining of the large intestine.

The presence of ulcers in the lining of the rectum and large intestine can also contribute to the occurrence of bloody stools.

9. Urgency To Have A Bowel Movement

People with ulcerative colitis may feel a sudden and strong urge to have a bowel movement, which can be difficult to control. This is typically a result of the inflammation in the lining of the intestines that characterizes the disease.

Inflammation of the intestinal lining can impede the absorption of fluids. This results in loose and watery stools. In some cases, the bowel becomes completely liquid. The loose consistency of stool can also accelerate its movement through the colon, leading to more frequent bowel movements.

Additionally, the inflammation caused by ulcerative colitis can lead to increased production of mucus in the colon. The mucus can further contribute to the sensation of urgency and the frequency of bowel movements.

8. Insomnia Or Lack Of Quality Sleep

People with ulcerative colitis experience a worsening of symptoms at night, including increased bowel movements or diarrhea. The necessity for frequent bathroom trips during the night can interrupt sleep and prevent someone from achieving restful, continuous sleep.

Adding to the complexity, the side effects of some medications used to treat ulcerative colitis can interfere with sleep. Corticosteroids, for instance, a common treatment for ulcerative colitis, can lead to insomnia or restless sleep.

Simultaneously, the stress and anxiety that can come with living with a chronic illness like ulcerative colitis can disrupt sleep as well. Worries about health, symptoms, or treatment can all create barriers to falling asleep or staying asleep.

7. Fatigue And Weakness

Experiencing intense fatigue is a symptom of ulcerative colitis, often characterized as a profound and persistent tiredness that rest or sleep fails to alleviate. This is not simply feeling tired, but a systemic exhaustion that permeates through every facet of one’s life.

This weariness can manifest physically, mentally, or encompass both, turning even the most mundane tasks like dressing up or showering into daunting chores. It’s as if the energy required for daily activities has been sapped, leaving a sensation of constant lethargy.

Along with this fatigue often comes a host of additional symptoms, making daily life even more challenging. These may include difficulties with focus, rendering even simple decisions complicated. The intensity of fatigue can differ among individuals and may change over time. For some, fatigue is a constant, unwavering presence, an incapacitating level of exhaustion that appears relentless.

6. Loss Of Appetite

Individuals with ulcerative colitis may lose their appetite, particularly during flare-ups. Their digestive system can get affected, causing them to lose their appetite. They may also experience abdominal pain and discomfort, which can make it difficult to eat or feel hungry.

The stress and anxiety associated with living with a chronic illness like UC can affect appetite and eating habits.

Additionally, ulcerative colitis often brings with it nausea or a feeling of fullness, further inhibiting the desire to eat. Symptoms such as diarrhea or bloody stools can also lead to a reluctance to eat due to fear of exacerbating these symptoms. In severe cases, these symptoms can also lead to malnutrition, further compounding the health challenges faced by individuals with UC.

5. Weight Loss

Chronic inflammation in the intestine can cause weight loss, especially if the person is not absorbing enough nutrients from food. Since the individual is more likely to lose appetite, weight loss becomes inevitable.

Since individuals with ulcerative colitis often experience chronic diarrhea, it becomes inevitable for them to lose weight. The water loss in their body can affect their weight.

4. Fever

Fever in ulcerative colitis can be caused by several factors, including inflammation in the colon and other parts of the body, infections, and the body’s immune response to the disease.

Fever is also a symptom of a rare form of ulcerative colitis called fulminant colitis. This could be caused by the rapid loss of muscle tone in the large intestine resulting in expansion within hours to days. Such expansion may lead to high fever and abdominal pain.

3. Joint Pain

Joint pain is the most prevalent non-digestive problem experienced by individuals with ulcerative colitis. The inflammatory conditions in ulcerative colitis may cause joint pain brought about by psoriatic arthritis, rheumatoid arthritis, peripheral arthritis, and axial arthritis.

There are different types of arthritis associated with ulcerative colitis, each presenting different patterns of joint involvement. These include psoriatic arthritis, rheumatoid arthritis, peripheral arthritis, and axial arthritis.

Joint pain in ulcerative colitis can also be a manifestation of more serious complications. While rare, there is a potential for cancer cells to invade healthy tissues in the joints, causing pain and dysfunction. This is more common in individuals with a long history of ulcerative colitis, as they have an increased risk of developing colorectal cancer.

2. Skin Rashes

Inflammation and immune system dysfunction are contributing factors to skin rashes in ulcerative colitis. The inflammation brought about by ulcerative colitis can also affect the skin.

This can cause rashes, such as erythema nodosum. This is a painful red rash that usually appears on the legs and it can be tender and warm. It may also be accompanied by joint pain or fever.

1. Eye inflammation

Inflammation caused by ulcerative colitis can also affect the eyes. It may result in a condition called uveitis or iritis, which is characterized by redness, pain, and sensitivity to light.

The immune system dysfunction associated with ulcerative colitis can also affect the eyes. In some cases, the immune system can mistakenly attack healthy tissues in the eyes, leading to inflammation and damage.

Treatment And Care

Ulcerative colitis can cause a range of uncomfortable and sometimes debilitating symptoms. Treating the disease can help reduce or eliminate these symptoms, improving quality of life.

Ulcerative colitis can also cause a number of complications, some of which can be serious and even life-threatening. These complications can include intestinal strictures, perforations, and colon cancer. Early treatment of the disease can help reduce the risk of these complications.

Furthermore, treating ulcerative colitis can also help improve long-term outcomes by reducing the likelihood of needing surgery, hospitalization, or other medical interventions.

Hence, treatment is critical once the individual is diagnosed with the disease. Below are ulcerative colitis treatments worth knowing.

14. Anti-Diarrheal Medications

Anti-diarrheal medications can help manage symptoms of ulcerative colitis, but they do not treat the underlying inflammation of the disease.

Anti-diarrheal medications such as loperamide work by slowing down the movement of the intestinal muscles, which can help reduce the frequency and urgency of diarrhea. They can also help thicken stool, making it easier to pass.

13. Pain Relievers

Pain relievers, such as Tylenol can help manage pain and discomfort associated with ulcerative colitis. However, there are some pain relievers that can aggravate symptoms and intensify the severity of the illness.

These medications can help reduce inflammation in the intestine, which may in turn alleviate pain and discomfort. It is important to discuss pain management strategies with a healthcare provider to ensure safe and effective treatment for ulcerative colitis.

12. Antispasmodics

In the treatment of ulcerative colitis, antispasmodics can be used to help relieve abdominal pain, cramping, and discomfort associated with the disease. These medications work by relaxing these muscles and reducing cramping and pain.

Examples of antispasmodics that may be used in the treatment of ulcerative colitis include dicyclomine (Bentyl) and hyoscyamine (Levsin). These medications are typically prescribed as needed for symptom relief, and they are generally well tolerated.

11. Iron Supplements

Iron supplements can help treat ulcerative colitis by addressing iron deficiency anemia, a common complication of this condition.

Iron supplements can help to replenish iron stores in the body and increase the production of hemoglobin, thereby improving symptoms of anemia. This can lead to increased energy levels and improved overall health and well-being.

10. Corticosteroids

Corticosteroids are anti-inflammatory drugs that work by suppressing the immune system’s response to inflammation. They can be given orally, topically, or intravenously.

Oral corticosteroids, such as prednisone, are often used to treat moderate to severe ulcerative colitis, while topical corticosteroids, such as rectal suppositories or enemas, are used to treat inflammation in the rectum.

Corticosteroids can provide quick relief from symptoms of ulcerative colitis, including abdominal pain and diarrhea. They can also help to reduce inflammation in the colon and promote the healing of the damaged tissue.

9. 5-Aminosalicylates

5-aminosalicylates, also known as 5-ASAs, are a group of medications that are derived from salicylic acid, which is the active ingredient in aspirin. They are typically given orally or rectally, and they work by reducing inflammation in the colon and rectum.

Oral 5-ASAs, such as mesalamine, sulfasalazine, and olsalazine, are used to treat mild to moderate ulcerative colitis. Rectal 5-ASAs, such as suppositories or enemas, are used to treat inflammation in the rectum.

These medications can provide quick relief from symptoms of ulcerative colitis, including abdominal pain and diarrhea. They can also help to reduce inflammation in the colon and promote the healing of the damaged tissue.

8. Azathioprine

Azathioprine works by inhibiting the production of white blood cells, including those that cause inflammation in the colon. It is typically used in combination with other medications, such as corticosteroids, to induce remission in patients with moderate to severe ulcerative colitis.

Once remission is achieved, azathioprine may be used as a maintenance therapy to prevent flare-ups.

7. Cyclosporine

Cyclosporine is an immunosuppressant medication that can help in the treatment of ulcerative colitis by suppressing the immune system’s response to inflammation.

It is effective in reducing inflammation and irritation in the intestines, thereby decreasing the need for long-term use of steroids. In certain cases, this medication can be used as a standalone treatment.

6. Medications Known As “Small Molecule”

A small molecule or targeted synthetic small molecules refer to medications that specifically target certain components of the immune system that contribute to inflammation in the intestine and other organs, thereby reducing inflammation.

At present, there are three targeted synthetic small molecules that have been approved by the FDA for the treatment of ulcerative colitis.

5. Infliximab

Infliximab is a type of medication known as a biologic drug that can help in the treatment of ulcerative colitis. It is a monoclonal antibody that targets a specific protein called tumor necrosis factor-alpha (TNF-alpha) which plays a key role in the inflammatory response in the colon.

It has shown effectiveness in individuals diagnosed with moderate to severe ulcerative colitis, as well as those with severe illness who did not respond to other medications.

4. Vedolizumab

Vedolizumab functions by inhibiting the infiltration of white blood cells into the gut lining. It solely targets the gut area, unlike anti-TNF drugs that affect the entire body and may result in fewer adverse effects.

Vedolizumab is administered via intravenous infusion and is typically given every 8 weeks. It may take several weeks to see a response and some people may require additional medications to manage their symptoms.

3. Ustekinumab

Ustekinumab is a medication that can be helpful in the treatment of ulcerative colitis. It can reduce inflammation, leading to a reduction in symptoms such as diarrhea, abdominal pain, and rectal bleeding.

Ustekinumab can be effective in treating moderate to severe ulcerative colitis in adults who have not responded well to other treatments. It is usually administered as an infusion in a hospital or clinic setting by a specialist.

2. Surgery

Surgery can be an effective treatment option for ulcerative colitis when other medical treatments have failed. The two main surgical options are total proctocolectomy with ileal pouch-anal anastomosis (IPAA) and colectomy with ileostomy.

Total proctocolectomy with IPAA involves the removal of the entire colon and rectum, which are replaced with a pouch made from the end of the small intestine.

Colectomy with ileostomy involves the removal of the colon and rectum, with the small intestine then being brought out through the abdominal wall to create an opening called an ileostomy. Waste products then pass out of the body through the ileostomy into a bag worn on the outside of the body.

1. Microbiome Approach

The microbiome approach to treating ulcerative colitis focuses on modifying the composition and function of the gut microbiota to restore balance and reduce inflammation. Alterations in the gut microbiome are thought to play a significant role in the disease.

Results of studies suggest that combining probiotics and prebiotics as a treatment strategy can help manage symptoms and promote remission of ulcerative colitis.

Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit to the host. They are often used to promote a healthy balance of gut bacteria. Certain strains of Bifidobacteria and Lactobacillus have been found to be beneficial in some studies, potentially by enhancing the gut barrier function and reducing inflammation.

Prebiotics are non-digestible food ingredients that beneficially affect the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon. Essentially, they serve as food for probiotics and other beneficial bacteria, helping them to thrive.

Learn More About Microbiome Approach To Treating Ulcerative Colitis.

These are ulcerative colitis symptoms and treatments worth knowing about.