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Ulcerative Colitis

Ulcerative Colitis is a type of inflammatory bowel disease. More precisely, Ulcerative Colitis is a chronic disease of the large intestine, also known as the colon.  With Ulcerative Colitis, the lining of the colon becomes inflamed and develops tiny open sores, or ulcers, that produce pus and mucous. The combination of inflammation and ulceration can cause abdominal discomfort and frequent emptying of the colon.

What is Ulcerative Colitis?

Ulcerative colitis

Ulcerative colitis is often limited to the rectum and lower colon but can involve the entire colon.

Ulcerative Colitis is the result of an abnormal response by your body’s immune system, in which the cells and proteins that normally make up the immune system to protect you from infection, mistake food, bacteria, and other materials in the intestine as foreign or invading substances. When this happens, the body sends white blood cells into the lining of the intestines, where they produce chronic inflammation and ulcerations.
It is important to understand the difference between Ulcerative Colitis and Crohn’s Disease.

Crohn’s Disease can affect any part of the Gastrointestinal (GI) Tract, but Ulcerative Colitis affects only the colon. Additionally, while Crohn’s Disease can affect all layers of the bowel wall, Ulcerative Colitis only affects the lining of the colon.  Although both Ulcerative Colitis and Crohn’s Disease are types of Inflammatory Bowel Diseases (IBD), they should not be confused with Irritable Bowel Syndrome (IBS), since that is a disorder which affects the muscle contractions of the colon and is not characterized by intestinal inflammation.

 

Lifestyle Management

You can lead a full life even if you have Ulcerative Colitis by keeping your symptoms under control. Do not allow this disease to isolate you. By planning ahead and working with support groups, you can find ways to cope. You may even help others who have Ulcerative Colitis.

 

Have a Plan

Make this your goal: “Ulcerative Colitis won’t keep me from the activities I enjoy.” You may need to do some planning to reach that goal. But by staying positive, you can help make sure you are in control–not Ulcerative Colitis.

Here are some other tips:

  • Know where to find clean bathrooms.
  • Eat more small meals instead of three big meals, especially when on the road or when you do not have easy access to bathrooms.
  • If you have had a recent flare­-up, eat foods that you know will limit your symptoms. Keep those foods on hand, both at home and at work.
  • Get some exercise every day.
  • Take a stress reduction class.
  • If going on a long trip, discuss your plans with your doctor. He or she can teach you what to do if you have a flare-up while on the road.

 

Find a Support Group

Ulcerative Colitis support groups can help you with many concerns you may have. Other people have felt much of what you may be feeling and just knowing that you are not alone can be a great comfort. Someone in a support group may offer a travel tip or a coping skill that is perfect for you. Do not forget how satisfying it can feel to help another Ulcerative Colitis patient who is in need.

 

Manage Your Nutrition

You may be able to eat most foods until you have a flare-up. But like anyone else, you need to make healthy eating choices. However, keep in mind that some of the healthiest foods can make symptoms worse. It may be helpful to keep track of the foods you have problems with.

 

Avoid Your Problem Foods

There is no rule for which foods can be a problem. How you feel after eating them is the best guide. You may need to avoid high-fiber foods and foods which are hard to digest. These can include fresh fruits and vegetables. High-fat foods, such as whole-milk dairy products and red meat, may also worsen symptoms.

Write down what you eat and how it affects you. If one kind of food often gives you trouble, stay away from it. Also note the foods that work well for you. Your doctor may have you see a nutritionist to come up with the best food choices for you. A nutritionist can help ensure that you eat foods that are safe while getting proper nourishment.

 

Foods That Are Often Safe

No two people respond the same to all foods, but these choices are often safe to eat during a flare-­up:

  • Applesauce, canned peaches or pears
  • Melba toast
  • Flavored gelatin, vanilla pudding, custard
  • White rice, plain pasta
  • Baked potatoes without the skin, mashed potatoes
  • Tuna packed in water
  • Skinless chicken
  • Instant oatmeal

 

Special Nourishment

In rare cases, the small intestine cannot absorb nutrients. Total parenteral nutrition (TPN) is a treatment that provides nourishment through an IV (intravenous) tube. This lets you get nutrition without eating, giving your digestive tract time to rest. If needed, TPN may also be used to help prepare for surgery. TPN can be done either in the hospital or at home with the aid of a home health nurse.

 

Management with Medications

Your doctor may prescribe medication to control your Ulcerative Colitis symptoms and improve your quality of life. Medication will not cure Ulcerative Colitis but it can help keep the disease from slowing you down. As always, work closely with your doctor. Your medication or dosage may need to be changed if you have certain side effects or if your symptoms change.

 

Anti-­Inflammatories

Special anti-inflammatories treat the lining of the intestine. These medications can reduce inflammation and discomfort. But they are not like aspirin or other over-the-counter medications in that they must be prescribed by a doctor. The most common anti-inflammatories for Ulcerative Colitis are called 5-ASA compounds. They can help control symptoms over long periods of time. 5-ASA compounds may be taken as pills, but they also can be taken as an enema or suppository (the medicine is put directly into the rectum).

Possible Side Effects of 5-ASA Compounds:

  • The 5-­‐ASA compound prescribed most often is in the “sulfa” family. Some of the possible side effects include:
    • headache
    • upset stomach
    • vomiting
    • skin rash
  • Less common but more severe side effects may include fever and heart or liver problems.

Severe side effects can be a sign of a sulfa allergy. If you have a sulfa allergy, your medication may need to be changed. Call your doctor if your side effects become severe.

 

Corticosteroids

Unlike 5­‐ASA compounds, corticosteroids are usually taken for short periods only. They should not be taken while in remission (a long period without severe symptoms).

Possible Side Effects of Corticosteroids:

  • Taken over time, corticosteroids can cause severe side effects.
  • They also may put you at risk for diabetes (a blood sugar problem).
  • Side effects may include:
    • mood changes
    • trouble sleeping
    • weight gain
    • puffy face or acne
    • changes in body shape
    • bone loss or fractures
    • high blood pressure
    • eye problems
    • facial hair (women)
    • stretch marks

 

Other Medications

Immunosuppressives treat the part of your body that fights disease (the immune system). By treating the immune system, inflammation may be reduced. Immunosuppressives can be taken for long periods of time. But you may need to see your doctor more often than usual for monitoring.

Antibiotics fight the bacteria that can lead to infections in some cases of Ulcerative Colitis. Some patients may get sores in the digestive tract. These sores then drain into other parts of the body which can lead to an infection. In some cases, antibiotics also help reduce inflammation.

 

Handling Side Effects

Our team of board certified gastroenterologists will discuss side effects. In most cases, side effects are easy to manage. But, sometimes they can become severe enough that you need to change medication.

Call us  (630) 527-6450 or use our online Request an Appointment form if you are having side effects that trouble you or that are unexpected.

 

Helpful Links

Suburban Gastroenterology