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FAQs:
What is Colitis?
Colitis is inflammation in your colon, which is the main part of your large intestine. Your colon is the last leg of the journey your food takes through your digestive system. Inflammation in your colon can affect the way this journey ends, causing pain, diarrhea, and sometimes blood in your poop. Inflammation is your body’s response to infection or injury. It causes swelling and tenderness in your tissues.
What is Ulcerative Colitis?
Ulcerative colitis is an inflammatory bowel disease (IBD) that causes inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine, also called the colon, and rectum. In most people, symptoms usually develop over time, rather than suddenly. Ulcerative colitis can be draining and can sometimes lead to life-threatening complications. While it has no known cure, several new treatments can greatly reduce signs and symptoms of the disease and bring about long-term remission.
What is Ischemic Colitis?
Ischemic colitis occurs when blood flow to part of the large intestine is temporarily reduced. This segment of the large intestine is called the colon. This reduced blood flow may be caused by the narrowing of the blood vessels supplying the colon. It also may be due to reduced blood flow caused by low blood pressure. The diminished blood flow doesn't provide enough oxygen for the cells in the digestive system. This can result in tissue damage to the affected area of the intestine. Any part of the colon can be affected, but ischemic colitis most commonly causes pain on the left side of the belly area. Ischemic colitis can be misdiagnosed because it can easily be confused with other digestive problems. You may need medicine to treat ischemic colitis or prevent infection. Or you may need surgery if your colon has been damaged. Most often, however, ischemic colitis heals on its own.
What is Lymphocytic Colitis?
Lymphocytic colitis is a type of microscopic colitis, which is a type of inflammatory bowel disease. Inflammatory bowel diseases are chronic diseases that cause ongoing inflammation in your intestines. Colitis means inflammation of the large intestine (colon). Microscopic colitis is colitis that can only be seen under a microscope. Scientists recognize the different types of microscopic colitis by analyzing the cells in your intestinal lining. Lymphocytic colitis is characterized by an abnormally high density of lymphocytes in your intestinal lining. Lymphocytes are a type of white blood cell. When they show up in large numbers, it usually means your immune system has been activated to fight off an infection. That’s what inflammation usually means, too. With lymphocytic colitis, there’s no infection, but your body acts as though there is.
Is Colitis a Serious Disease?
There are different types of colitis, with different causes. Some are short-lived and easy to treat, like when you have a bacterial infection from food poisoning. Other types — called inflammatory bowel diseases — are more chronic and difficult to treat. Colitis is more serious when it doesn’t go away. A severe case can do serious damage to your colon over time. It also affects your quality of life.
Which is Worse Crohn's or Colitis?
Although ulcerative colitis and Crohn’s disease are both long-term, inflammatory conditions that affect the digestive tract, ulcerative colitis (UC) may be considered “worse” because surgery may be required earlier and, in certain circumstances, more urgently, in people with severe and extensive UC. With sudden, severe UC, medications and intravenous steroids are unable to control the symptoms, and rarely, uncontrolled bleeding can occur from deep ulcerations in the colon. Severe, sudden UC can also lead to toxic megacolon (a rapid enlargement of the colon) which is a potentially life-threatening complication caused by severe inflammation that requires immediate surgery. Symptoms include severe pain, distension or bloating of the abdomen, fever, rapid heart rate, constipation, and dehydration.
Is Ulcerative Colitis an Autoimmune Disease?
Ulcerative colitis (UC) is an autoimmune-related disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. It is one of a group of diseases called inflammatory bowel disease. UC can happen at any age, but it usually starts between the ages of 15 and 30. It tends to run in families. The most common symptoms are pain in the abdomen and blood or pus in diarrhea.
Does Colitis Go Away?
Acute colitis that is caused by a temporary infection, food intolerance, or radiation exposure typically goes away by itself. Some types of infections may need treatment to go away, especially parasite infections. Most infections take about a week to go away, while radiation colitis takes a few months. Allergic colitis goes away when the substance your child was allergic to has cleared from their body.
Colitis which is an acute reaction to a chronic condition needs treatment to go away. Ischemic colitis resulting from intestinal ischemic syndrome won’t go away until blood flow is restored to your colon. Diversion colitis in people with colostomies won’t go away until the colostomy is reversed and the full use of your colon is restored (anastomosis surgery). In some people, these solutions aren’t possible.
Chronic colitis which is caused by inflammatory bowel disease is a lifelong condition. It won’t go away forever, but it can go away for a while. This is called remission. Treatment for IBD is focused on improving your symptoms and making remission last as long as possible. This is also true if your colitis is caused by another condition that can’t be cured. In some cases, surgery can make it go away.
Is Ulcerative Colitis Genetic?
One of the single biggest risk factors for UC and Crohn’s disease is a family history of the disease. About 10% to 25% of people diagnosed with UC have a parent or sibling with IBD. You’re four to eight times more likely to develop some type of IBD if you have a close relative with the condition. Researchers have found changes, or variants, in several genes that they think are linked to UC. They theorize that these variants might cause your immune system to overreact to normal bacteria in your gut, or affect the protective barrier in the lining of your intestine.
What is the Life Expectancy of Someone with Ulcerative Colitis?
If you have ulcerative colitis (UC), your life expectancy is pretty much the same as someone without it. Getting the right medical care is the key to preventing complications, including some that could be life-threatening. Medicine, changes to your diet, and surgery can help you stay well. Make sure you keep in touch with your doctor. If your symptoms come back, they can help you find new ways to control your disease. That will lower your chances of getting sick from UC.
Types of Colitis
There are several types of colitis, with different causes and prognoses:
1. Ulcerative colitis is an inflammatory bowel disease (IBD) that causes inflammation and ulcers (sores) in the digestive tract. Typically, ulcerative colitis starts in the rectum and can extend continuously into the colon, involving parts or all of the colon. Occasionally, only the colon is inflamed, and the rectum is normal. Ulcerative colitis can be controlled with medication, but it can only be cured by surgically removing the affected parts of the colon or the colon and rectum. Patients with ulcerative colitis often undergo a surgery called an ileal pouch-anal anastomosis, referred to as a “J-pouch” as the intestine is formed into the shape of a “J” so the patient does not have a permanent ostomy.
2. Crohn’s disease is another type of inflammatory bowel disease that can be controlled but not cured, causing flare-ups of chronic inflammation in the digestive tract. Crohn’s disease can occur anywhere throughout the gastrointestinal tract, not only in the colon and rectum like ulcerative colitis, but can be confused with ulcerative colitis. Ongoing research is being performed to determine the role and timing of surgery and medical therapy.
3. Infectious colitis is a type of colitis that results from viral, parasitic, or bacterial infections that can typically be treated and controlled with medications and temporary dietary changes.
4. Pseudomembranous colitis is an inflammation of the colon associated with an overabundance of the bacterium Clostridioides difficile.
5. Ischemic colitis occurs when blood flow to the large intestine is temporarily reduced.
6. Radiation colitis results from exposure to radiation therapy.
Signs & Symptoms of Colitis
Common symptoms of colitis include:
- Abdominal pain and bloating
- Blood in the stool
- Diarrhea
- Fever
- Loss of appetite and unintended weight loss
Contact your doctor if you experience any of these more acute symptoms:
- Abdominal pain that doesn’t go away
- Blood in the stool, or stools that appear black after a bowel movement
- Nausea and vomiting
- Diarrhea that doesn’t go away
- Swollen abdomen
Causes of Colitis
The cause of colitis is still not entirely understood. Researchers typically attribute the inflammation to improper immune system response, poor diet, processed foods, and increased stress, which irritate inflammation and make colitis more severe. The following risk factors can cause individual cases of colitis:
- Bacterial or viral infections
- Food poisoning
- Crohn’s disease and ulcerative colitis
- Lack of blood flow (ischemic colitis)
- Radiation exposure to the large bowel
- Family inheritance
Complications of Colitis
Complications usually result from severe, long-term, chronic colitis. They can include:
1. Perforation. Chronic inflammation weakens your colon walls, making them more likely to rupture. An ulcer in your colon may wear a hole all the way through. This can cause bacteria from your colon to infect your abdominal cavity (peritonitis) and possibly your bloodstream (septicemia), which would be especially dangerous. Septicemia can lead to sepsis.
2. Toxic megacolon. Severe inflammation can cause the walls of your colon to dilate (widen) and interfere with its natural muscle contractions (peristalsis). This can trap food and gas in your colon (large bowel obstruction). Obstruction leads to painful abdominal distension and an increased risk of rupture.
3. Increased risk of colon cancer. Long-term inflammation is associated with cellular changes in your colon wall that can sometimes progress to cancerous changes. The risk increases rapidly after the first decade of chronic colitis.
4. Increased risk of other inflammatory diseases. People with inflammatory bowel diseases are more likely to have other inflammatory diseases in other parts of their bodies. Some examples include osteoarthritis (joint inflammation) and primary sclerosing cholangitis (inflammation in your liver and bile ducts). It appears that uncontrolled inflammation in one area may trigger a similar process somewhere else.
How to Test and Diagnose Ulcerative Colitis
To diagnose ulcerative colitis, doctors review medical and family history, perform a physical exam, and order medical tests. Doctors order tests to
1. confirm the diagnosis of ulcerative colitis
2. find out how severe ulcerative colitis is and how much of the large intestine is affected
3. rule out other health problems—such as infections, irritable bowel syndrome, or Crohn's disease—that may cause symptoms similar to those of ulcerative colitis
A. Medical and Family History
To help diagnose ulcerative colitis, your doctor will ask about your symptoms, your medical history, and any medicines you take. Your doctor will also ask about lifestyle factors, such as smoking, and your family medical history.
B. Physical Exam
During a physical exam, your doctor may
1. check your blood pressure, heart rate, and temperature—if you have ulcerative colitis, doctors may use these measures, along with information about your symptoms and test results, to find out how severe the disease is.
2. use a stethoscope to listen to sounds within your abdomen.
3. press on your abdomen to feel for tenderness or masses.
The physical exam may also include a digital rectal exam to check for blood in your stool.
C. Run Some Tests
Doctors may use blood tests, stool tests, and endoscopy of the large intestine to diagnose ulcerative colitis.
1. Blood tests
A healthcare professional will take a blood sample from you and send the sample to a lab. Doctors use blood tests to check for signs of ulcerative colitis and complications, such as anemia. Blood tests can also show signs of infection or other digestive diseases.
2. Stool tests
A healthcare professional will give you a container for catching and storing the stool. You will receive instructions on where to send or take the container for analysis. Doctors may use stool tests to check for conditions other than ulcerative colitis, such as infections that could be causing your symptoms. Doctors may also use stool tests to check for signs of inflammation in the intestines.
3. Endoscopy of the large intestine
Doctors order endoscopy of the large intestine with biopsies to diagnose ulcerative colitis and rule out other digestive conditions. Doctors also use endoscopy to find out how severe ulcerative colitis is and how much of the large intestine is affected.
Two types of endoscopy used to diagnose ulcerative colitis are
- colonoscopy, in which a doctor uses a type of endoscope called a colonoscope to view the lining of your rectum and your entire colon.
- flexible sigmoidoscopy, in which a doctor uses a type of endoscope called a sigmoidoscope to view the lining of your rectum and lower colon
8 Ways to Prevent or Stop an Ulcerative Colitis Flare-Up
Experiencing an ulcerative colitis (UC) flare and feeling desperate to stop it or, better yet, keep the next flare from happening? Flares can be difficult to manage and often interfere with daily living. Stopping or preventing them can improve your quality of life and make you feel like you’re in control again. Symptoms of a UC flare may vary depending on the severity of the inflammation and where it occurs. Generally, the most common symptoms are abdominal pain, cramping, and diarrhea (which may contain pus or bloody stools).
To better understand how flares can be stopped or prevented, here are eight ways people with ulcerative colitis can reduce symptoms during flares.
1. Optimize Your Medications
Although there’s no cure for ulcerative colitis, a growing number of effective therapies can improve symptoms. It’s important to regularly talk with your gastroenterologist about how well your symptoms are controlled and if any change in your medications, like a different dose or new drug, would be beneficial. A variety of medications are often prescribed to reduce symptoms.
2. Manage Your Stress
Stress from living with ulcerative colitis can worsen symptoms and lead to flares. Researchers have found that stress triggers a series of reactions in the body that can ultimately increase inflammation of the small and large intestines.
3. Engage in Exercise
If your flare is due to active disease, medications and certain lifestyle changes — including exercise — may help you manage flare symptoms. You may ease abdominal pain and joint symptoms by getting regular exercise, such as practicing yoga — as well as other forms of mindfulness and stress management, as discussed above.
4. Understand Your Surgical Options
Surgery may be used to manage UC symptoms when other treatment options don’t get the disease under control. Although surgery can often eliminate ulcerative colitis, it may require removing the entire colon and rectum in a procedure called a total proctocolectomy. Some people later have another procedure called ileal pouch-anal anastomosis to create a J-pouch.
5. Improve Your Sleep Schedule
Disrupted sleep cycles have been found to increase immune system activity and inflammation, which could hurt UC flare-ups.
6. Keep an Eye on Your Diet
For some people with ulcerative colitis, certain foods can trigger flare-ups. Diet may affect the microbiome — bacteria and other microorganisms that live in the gut. When ulcerative colitis is in a period of remission (symptoms ease or disappear), high-fiber foods should be safe — and can even be beneficial for most people. Although there’s no one-size-fits-all approach to diet with ulcerative colitis, you may want to avoid potential trigger foods that are hard to digest and can increase your symptoms. Keeping a food diary may help you track how certain foods, such as spicy foods or dairy products, affect your symptoms during flare-ups and remission. Always talk with your doctor or a registered dietitian before adopting a new diet plan.
7. Regularly Monitor Your Ulcerative Colitis
Importance of regularly monitoring UC progression to catch issues before they prompt flare-ups. Routine monitoring includes getting regular blood work, attending all scheduled appointments, and having an annual disease evaluation (which may include stool testing or a colonoscopy).
8. Consider Alternative Treatments
Generally, people living with ulcerative colitis should always be on medication to manage symptoms, but some people feel better when they’re also taking fish oil, probiotics, or herbal supplements. Alternative treatments such as acupuncture or biofeedback also help some people.
Kinds of Diet for People with Colitis
Your healthcare provider may suggest one or several of these diets, depending on the type of colitis you have:
1. Low-residue diet. A low-residue diet is easy to digest when your symptoms are acute or severe. It limits fiber and fat and emphasizes soft, well-cooked foods. If you have a temporary infection or radiation colitis, your healthcare provider may recommend a low-residue diet.
2. Anti-inflammatory diet. To keep chronic inflammation low, your healthcare provider might recommend you avoid highly inflammatory foods, especially fast and processed foods high in sugar and fat. They might suggest more healthy, unsaturated fats to calm inflammation, like olive oil, avocados, nuts, and oily fish. The Mediterranean diet is naturally anti-inflammatory.
3. Elimination diet. If you have an inflammatory bowel disease, your healthcare provider will likely recommend an elimination diet to isolate the foods that cause your symptoms to flare up. An elimination diet eliminates certain types of foods and then adds them back in a systematic way so that you can observe how your gut responds to them. After the temporary elimination diet, you can use what you learned to design a personalized, long-term maintenance diet.
Foods to Eat If You Have Ulcerative Colitis
When experiencing a UC flare-up, the best foods to eat are those that provide sufficient nutrients without worsening your symptoms. Speak with your healthcare provider or a nutritionist to help you find the foods that best meet these needs.
1. Low-fiber fruits are an ideal part of a UC diet and include:
- Applesauce
- Apricots (ideally skinned)
- Bananas
- Cantaloupes
- Cooked or canned fruit
- Fruit juices without pulp
- Honeydew melons
- Nectarines (ideally skinned)
- Papayas
- Peaches (ideally skinned)
- Plums (ideally skinned)
- Watermelon (seeded)
2. Vegetables that are low in fiber and residue include:
- Beets (cooked)
- Canned vegetables (without seeds or skins)
- Carrots (cooked)
- Cucumber (peeled and without seeds)
- Potatoes (without skins)
- Spinach (pureed)
- Squashes (like butternut and acorn squash)
- String beans (well-cooked)
- Tomato sauces
- Vegetable juice (strained)
3. Lean protein is also ideal whether you have active UC symptoms or not. These include plant- and meat-based proteins like:
- Canned tuna (packed in water)
- Cottage cheese (low-fat)
- Eggs (not fried)
- Fish (skinless)
- Hummus
- Peanut butter powder
- Pork (lean and trimmed)
- Poultry (without skin)
- Seitan
- Tofu
- Yogurt (plain)
4. Refined grains that are suitable for UC flare-ups include:
- Cornflakes
- Cream of wheat
- Farina
- Grits
- Melba toast
- Oatmeal
- Pasta and noodles
- Puffed rice cereal
- Saltines and other plain crackers
- White bread
- White rice
Foods to Avoid If You Have Ulcerative Colitis
During a flare-up, it's best to avoid foods that either create residue, are gassy, or can irritate the bowel. These include sugary, fatty, or processed foods, all of which are inflammatory and affect normal bowel function. The list is extensive and includes:
- Alcohol
- Baked goods, like cakes, muffins, and brownies
- Candies and chocolate
- Coffee and other caffeinated beverages
- Dairy (if lactose intolerant)
- Dried beans and legumes
- Dried fruits
- Fast food
- Fried foods
- Fatty cuts of meat
- Gassy cruciferous vegetables, like cabbage, broccoli, and cauliflower
- Nuts and seeds
- Processed meats, like bacon and sausages
- Raw fruits with seeds or skins, like berries and unpeeled apples
- Raw vegetables
- Sodas and other carbonated beverages
- Sugary drinks, including high-sugar fruit juice
- Spicy foods, like curries and chili
- Whole grains, like brown rice, quinoa, and wild rice
- Whole-grain products, like whole-grain bread, pasta, and cereal
How to Treat Colitis
Treatment for colitis depends on the type and the cause. It may include:
1. Medications. Your provider may prescribe antibiotics to treat infections, corticosteroids to treat inflammation, immune modifiers to repress your autoimmune response, and aminosalicylates to treat IBD.
2. Diet. If you have temporary, acute colitis, you may benefit from a low-fiber, easy-to-digest diet. If you have chronic colitis, you may need a personalized diet plan. You may need to avoid foods that trigger your colitis flare-ups and incorporate other foods or supplements to make sure you get adequate nutrition.
3. Surgery. People with certain types of colitis, including necrotizing enterocolitis, ischemic colitis, and IBD, may require surgery to treat complications. Surgery doesn't always cure these conditions, but it may be necessary to stop bleeding, repair a perforation, or remove a blockage.
Finding the Right Ulcerative Colitis Specialist Near Me
If you have ulcerative colitis, finding the right specialist can help you manage your symptoms in the short term and maintain your overall health over the long term.
The symptoms of ulcerative colitis can have a major impact on your quality of life. Finding a doctor you feel comfortable with and who knows your condition can help you get the best control of your symptoms. Start with these steps.
1. Consider seeing a specialist. A gastroenterologist is trained in the medical management of ulcerative colitis, and large practices often have a doctor with inflammatory bowel disease (IBD) specialty, says Gil Melmed, MD, director of IBD clinical research at Cedars-Sinai in Los Angeles and cochairperson of the Crohn’s & Colitis Foundation’s IBD Qorus, a quality-of-care initiative.
Gastroenterologists also do colonoscopies. The test is “a very important tool for understanding, evaluating, and assessing the state of colitis, which enables treatment decisions,” says Dr. Melmed. A gastroenterologist can also help you find the right medication to address the digestive tract inflammation causing your symptoms. If you live in an area with fewer choices of specialists, and you’re only to see them once or twice a year, it’s a good idea to see a local doctor, such as a primary care physician, for regular care.
2. Use an online directory. If you don’t know where to start to find a specialist, you can use the physician directory on the Crohn’s & Colitis Foundation’s website or check the websites of other associations, such as the American College of Gastroenterology.
3. Ask for recommendations. If you feel comfortable doing so, you could ask your current doctor for recommendations. Other people who are living with ulcerative colitis can be another valuable resource. Asking them for doctor references can help guide you to the right place, and joining an ulcerative colitis support group is a great way to network and exchange information.
4. Make some phone calls. If you have a list of doctors to try but aren’t sure which one will be best for you, it may be worth calling the office and asking how many ulcerative colitis patients the doctor sees, to get a sense of how much experience the physician has with the condition, Melmed advises.
5. Aim for a long-term relationship. A good physician will treat not just the disease but also you as a person and help you understand the impact of the condition on your quality of life. You’ll be seeing your physician for a long time, so it’s important to have a good working relationship with them.
6. Consider a hospital system. As many as 45 percent of people with ulcerative colitis may need surgery, according to the Crohn’s & Colitis Foundation. It’s not necessary to get routine care at a hospital that specializes in ulcerative colitis surgery, but finding one within your insurance network is something to consider.
As you conduct your search for the right doctor, be sure your medical records follow you. It can be tricky for a doctor to see new patients when the records aren’t available. Either make sure your records precede you to the new office or bring them with you to ensure you get the best care from the start.
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