Book an Appointment
Emergency: 022-61305005
I want to find
My Health Records
Management Team

Ulcerative colitis

Overview

Ulcerative Colitis (UC) is a chronic inflammatory bowel disease (IBD) that primarily affects the colon (large intestine) and rectum. It is characterised by inflammation and ulceration of the mucosal lining of the colon, leading to symptoms such as diarrhoea, abdominal pain, and rectal bleeding. UC is considered an autoimmune condition, though its exact cause is not fully understood.

  • Diarrhoea (often with blood or mucus)
  • Abdominal pain or cramping
  • Rectal bleeding
  • Urgency to have bowel movements
  • Fatigue
  • Weight loss
  • Fever (in severe cases)
  • Anaemia (due to blood loss)

  • Genetics: A family history of IBD increases the risk.
  • Age: UC often develops in early adulthood (ages 15–30) but can occur at any age.
  • Ethnicity: UC is more common in individuals of Jewish descent, particularly Ashkenazi Jews.
  • Environment: Living in urban areas and industrialised countries is associated with a higher risk of UC, suggesting environmental factors, including diet and hygiene, may play a role.

Diagnosis of UC is based on a combination of clinical presentation, laboratory tests, imaging, and endoscopic evaluation.

  • Colonoscopy: The gold standard for diagnosis. It allows direct visualisation of the colon and rectum, showing characteristic ulcers, inflammation, and mucosal changes.
  • Biopsy: Small tissue samples are taken during colonoscopy to confirm the diagnosis.
  • Stool tests: To rule out infections that could mimic UC symptoms.
  • Blood tests: To check for anaemia, elevated white blood cell count (inflammation), or other signs of disease activity.

While there is no cure for UC, treatment focuses on managing symptoms, inducing remission, and preventing flare-ups.

  • Medications:
    • Aminosalicylates (5-ASA): Such as sulfasalazine, mesalamine. These help reduce inflammation in the colon.
    • Corticosteroids: For short-term control during flare-ups, but not for long-term use due to side effects.
    • Immunomodulators: Such as azathioprine or methotrexate to suppress the immune system and prevent inflammation.
    • Biologics: TNF inhibitors (e.g., infliximab, adalimumab) and other biologic agents (e.g., vedolizumab, ustekinumab) target specific parts of the immune response.
    • Janus kinase inhibitors (e.g., tofacitinib): A newer class of drugs for moderate-to-severe UC.
  • Dietary modifications:
    • No specific diet can cure UC, but during flare-ups, a low-residue or low-fibre diet may be recommended to reduce irritation.
    • Maintaining good hydration and addressing nutrient deficiencies (e.g., iron, vitamin D) is important.
  • Surgery:
    • If UC is severe, unresponsive to medication, or causing complications, surgery may be required. The most common procedure is a colectomy, which involves removing the colon. In some cases, an ileoanal pouch is created, allowing the patient to have normal bowel movements.
  • Psychosocial support: Chronic illnesses like UC can have a psychological impact, and managing stress is often part of the treatment plan. Support from mental health professionals or joining support groups can be helpful.
Bottom to top