Ulcerative Colitis (Causes, Risk factors, and Complications)
Definition: Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that causes long-lasting inflammation and ulcers (sores) in our digestive tract. It occurs when the lining of our large intestine (also called the colon), rectum, or both become inflamed. This inflammation produces tiny sores called ulcers on the lining of our colon. It usually begins in the rectum and spreads upward. It can involve our entire colon.
It’s important not to confuse an inflammatory bowel disease (IBD) like ulcerative colitis or Crohn’s disease with irritable bowel syndrome (IBS). IBS is a disorder that affects the muscle contractions of the bowel and is not characterized by intestinal inflammation, nor is it a chronic disease.
The primary symptoms of active disease are abdominal pain and diarrhea mixed with blood. Weight loss, fever, and anemia may also occur. Often, symptoms come on slowly and can range from mild to severe. Symptoms typically occur intermittently with periods of no symptoms between flares. Complications may include megacolon, inflammation of the eye, joints, or liver, and colon cancer.
While this disease affects people of all ages, most people are diagnosed between the ages of 15 and 35. After age 50, another small increase in diagnosis for this disease is seen, usually in men.
Ulcerative colitis can be debilitating and can sometimes lead to life-threatening complications. While it has no known cure, treatment can greatly reduce the signs and symptoms of the disease and even bring about long-term remission.
Causes and Risk factors of Ulcerative colitis: The exact cause of UC is not known, but researchers believe ulcerative colitis is caused by a combination of factors that involve genetics, the environment, and an overactive immune system. It is not caused by something people ate.
- Genetics: About one-fifth of people with ulcerative colitis have a close relative who has had the same disease, suggesting that the disease can be inherited.
- Environmental: Diet, air pollution, cigarette smoke, and poor hygiene may contribute.
- Immune system: One possibility is that the body’s response to a viral or bacterial infection causes the inflammation linked to ulcerative colitis. After the infection has gone, the immune system continues responding, resulting in ongoing inflammation.
Ulcerative colitis is an autoimmune disease characterized by T-cells infiltrating the colon. In contrast to Crohn’s disease, which can affect areas of the gastrointestinal tract outside of the colon, ulcerative colitis usually involves the rectum and is confined to the colon, with occasional involvement of the ileum. This so-called “backwash ileitis” can occur in 10–20% of patients with pancolitis and is believed to be of little clinical significance.
One study has found that one-third of all cases are linked to a high intake of linoleic acid, a common fatty acid. It can be found in red meat, several cooking oils, and some types of margarine.
Ulcerative colitis affects about the same number of women and men. Risk factors may include:
- Age. Ulcerative colitis usually begins before the age of 30. But, it can occur at any age, and some people may not develop the disease until after age 60.
- Race or ethnicity. Although whites have the highest risk of the disease, it can occur in any race. If people are of Ashkenazi Jewish descent, their risk is even higher.
- Family history. People are at higher risk if they have a close relative, such as a parent, sibling or child, with the disease.
Isotretinoin (Accutane). This medication is sometimes used to treat severe acne. It is unclear how this medication may be linked to ulcerative colitis.
Complications of Ulcerative colitis: The complications of ulcerative colitis range from a lack of nutrients to potentially fatal bleeding from the rectum. Ulcerative colitis increases people’s risk of colon cancer. The longer people have the disease, the higher their risk of this cancer. Regular screening helps lower their risk of colon cancer.
Other complications of ulcerative colitis include:
- thickening of the intestinal wall
- sepsis, or blood infection
- severe dehydration
- toxic megacolon, or a rapidly swelling colon
- liver disease (rare)
- intestinal bleeding
- kidney stones
- inflammation of their skin, joints, and eyes
- rupture of their colon
- ankylosing spondylitis, which involves inflammation of joints between their spinal bones
To prevent a loss of bone density, a doctor may prescribe vitamin D supplements, calcium, and other medications. Attending regular medical appointments and being aware of symptoms can help prevent these complications.