UC is a type of inflammatory bowel disease (IBD) that produces inflammation and sores or ulcers along the inside of the large intestine, also called the bowel or colon. The sores may interfere with the normal digestive process, often causing cramping, bloating, diarrhea, bleeding, fatigue, weight loss and frequent bowel movements.
Populations affected
- Nearly 700,000 Americans have UC
- Ulcerative colitis usually starts in people aged 15 to 30
- Ulcerative colitis affects men and women equally
- Ulcerative colitis is found worldwide, but is most common in the United States and northern Europe
- Individuals of Eastern European Jewish descent are three to five times more likely to develop UC
Cause of UC
The cause of UC is unknown, although studies have shown that up to 20% of people with UC will have a close relative with IBD. However, based on research, there is not a typical pattern of inheritance.
Diagnosis
Physicians diagnose UC from a patient's personal history, a physical exam and a series of tests which often include blood tests, stool samples and internal imaging tests, such as a sigmoidoscopy or colonoscopy.
Treatments
Currently there is no cure for UC, but the following treatments may help manage the symptoms, according to the American College of Gastroenterology:
- Aminosalicylates: Drugs in this class, including mesalamine and sulfasalazine, contain 5-aminosalicylic acid (5-ASA) to help control inflammation. 5-ASAs are the treatment of choice for mild to moderate UC and most patients are treated with this group of drugs first
- Corticosteroids: Corticosteroids suppress the inflammatory process in the colon. They may be used for patients with moderate to severe UC who have not responded to 5-ASA treatment. They are not recommended for long-term use because of negative side effects such as weight gain, acne, facial hair and mood swings
- Immunomodulators: The medications in this class interrupt the immune system which plays an important role in the inflammatory symptoms of UC. Immunomodulators are usually prescribed for patients who have not responded to 5-ASAs or corticosteroids. These drugs are slow-acting and can take up to six months to reach their full benefit
- Biologics therapies: Biologics interfere with the body's inflammatory response in IBD by targeting particular enzymes and proteins that have already been proven defective, deficient, or excessive in people with IBD. The most common side effects of biologic therapies may include respiratory infections (such as sinus infections and sore throat), headache, rash, coughing, and stomach pain. Some rare, but serious side effects of these therapies have been reported, including tuberculosis, pneumonia, lymphoma and heart failure
- Surgical Options: If drug therapy does not alleviate symptoms, surgery may be necessary to remove the colon and rectum. Approximately 25% to 40% of UC patients have their colons removed
Risk of Colon Cancer
The risk of colon cancer increases with the duration of the disease and how much of the colon is damaged. Individuals with UC should consult their physicians to create a plan to regularly monitor their condition.
Living with UC
UC is a chronic illness and is usually not fatal. Most patients can manage their symptoms and maintain healthy and happy lives. Some challenges that arise with UC patients include:
- Medication compliance and pill burden. Most currently available UC treatments require multiple pills to be taken several times daily. In fact a recent study conducted by the CCFA shows that 65% of patients were poorly compliant with their current therapy citing pill burden and inconvenience associated with the medication as key reasons
- Emotional stress. Patients should receive emotional support and understanding from friends and family members.
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