Colitis

Ulcerative colitis, to give it its full name, is a disease that affects around 120,000 people in the UK.
It causes inflammation of the large intestine or colon, which is the last part of the intestine closest to your bottom.

What cases colitis and who can get it?

The exact cause of ulcerative colitis is not known, which makes it difficult to prevent.
It is believed the disease is associated with the dysfunction of the immune system, which is your body's system for protecting itself and fighting germs and infection.

In people with colitis, the immune system responds in a funny way. It makes the cells designed to protect the body actually attack the lining of the bowel, making it inflamed.

The immune system then takes this inflammation to be a further sign of infection – increasing the immune response and creating a vicious cycle.

People with colitis suffer from symptoms in bouts at times when the condition flares up. This can happen for different reasons, called triggers.

Some common triggers include illnesses like gastroenteritis or taking certain medications.

Ulcerative colitis is more common than Crohn's disease, another inflammatory bowel condition. It most often occurs in Caucasians, particularly those of Jewish descent.

People with the condition usually notice symptoms between the ages of 15 and 35, but they can appear earlier or later in life. The condition can also run in families.

What are the signs and symptoms of colitis?

Because the symptoms only usually show up in a flare-up, they can sometimes only occur months or years apart.

During mild flare-ups symptoms may appear over a few days and include:

Diarrhoea
Tiredness
Nausea
Tummy pains
Poor appetite.

In severe attacks, the symptoms come on suddenly and may include:

Severe diarrhoea many times a day
Passing of blood and mucus
A fever
Tummy pain
Swelling
Weight loss.

How dangerous is colitis?

A potentially fatal complication of colitis is extreme inflammation of the colon (called toxic megacolon), which may result in a tear in the bowel called a bowel perforation.

Colitis can also increase the risk of bowel cancer.

How is colitis normally diagnosed and treated?

If you are suffering from the symptoms of colitis, your doctor will probably refer you to a specialist at a hospital for further tests.

Diagnosis is generally made after an inspection of the colon by a hospital consultant. This test is called a colonoscopy.

You will usually be given a sedative or anaesthetic to help you to relax during the procedure. A colonoscope is then inserted into your bottom and up into the colon. The colonoscope has a little camera on it with a light so the operator can have a look around.

The operator may take small samples of some parts of the inside lining of the colon. This is painless and the samples are sent to the lab for testing.

If you are diagnosed as having colitis, your specialist will discuss treatment options with you.
Treatments may include changing your diet. A dieticianwill be able to tell you what you can and can't eat to prevent a flare up.

Your doctor may also prescribe medication which help to control an attack, stop diarrhoea and reduce inflammation. You may also be given immune suppressants which are drugs used to prevent further attacks.

Other treatments for colitis include something called monoclonal antibodies that are given by injections on two to eight week intervals to control the inflammation.

You may also need to have further colonoscopies to check your response to treatment and if it needs to be adjusted.

In very serious cases, doctors may suggest surgery to remove severely diseased parts of bowel. This will happen if there is a perforation or if cancer has developed.

A quarter of people with long term ulcerative colitis eventually need to have the colon removed.

When to ask for medical help

Always seek the advice of a doctor if you have the symptoms of colitis. You should also seek help if you have been diagnosed and suffer a flare up.

What's going to help?

Some people are embarrassed about getting the advice of a doctor for complaints involving their bowel.

It is important you realise that this can be a very serious condition and one which can be treated and managed if you seek help.

There is nothing to be embarrassed about. Doctors have seen and heard it all before.

Looking forward

With help from a doctor you can manage your symptoms. You should get proper guidance on how to control and manage your diet, and how to avoid too much stress as this can make flare-ups worse.

This is a fairly common condition and there are lots of people you can talk to to find out more.