What is ulcerative colitis?
Ulcerative colitis (UC) is a chronic disease that causes inflammation in the rectum, colon (large intestine), and infrequently the last part of the small intestine (ileum). The inflammation affects the inner lining of the colon, causing small sores, or ulcers. UC, along with a similar condition known as Crohn's disease, are collectively called inflammatory bowel disease (IBD).
What are the symptoms of UC?
Common symptoms of UC include bloody diarrhea, fever and abdominal pain. There can also be symptoms outside the digestive system which are known as extra-intestinal symptoms.
Diarrhea is a common symptom of UC. Because the colon is inflamed, it is not as efficient at absorbing water and nutrients from food. Frequent diarrhea can lead to dehydration and nutritional deficiencies.
When the lining of the colon becomes inflamed and ulcerated, it bleeds, causing blood to be passed in the stool. Blood from UC is often thick and darker in color as opposed to the bright red color of fresh blood. Mucus, which is white or yellow in color, may also be passed in the stool. The blood and mucus may occur together, or there may be occasions where just mucus is passed along with the stool.
Fever is a characteristic of the inflammatory process that takes place in UC. Fevers may be either high or low-grade and are present especially during periods of active disease (flare-ups). Night sweats can be caused by a fever spiking repeatedly during the night.
Extra-intestinal symptoms are those symptoms that are not directly related to the inflammation in the colon, and include eye inflammation, joint pains, skin rashes or lesions, and mouth ulcers. It's unclear why symptoms occur outside the colon in people who have UC. However, these extra-intestinal symptoms often track with the course of the IBD: during a flare-up they worsen, and during periods of remission they improve.
Eye conditions that can occur with UC include conjunctivitis, episcleritis, uveitis, and iritis. Most eye conditions will improve when progress is made in treating the underlying UC, but some may require treatment. Conjunctivitis, or “pink eye,” is an inflammation of the tissue covering the eye and inner surface of the eyelid and may be treated with antibiotics. Uveitis is the inflammation of the middle layer of the eye wall and symptoms include light sensitivity, pain, redness, blurred vision and headaches. Uveitis is commonly treated with corticosteroids; if left untreated it could result in glaucoma or detached retina. Inflammation in the white of the eye is called episcleritis, symptoms include pain and reddening, and treatment is with a vasoconstrictor or corticosteroid. Iritis is inflammation in the iris and symptoms include pain, light sensitivity, blurred vision, redness, decreased pupil size, and floaters. Steroids and antibiotics may be used to treat iritis.
Joint pains may be peripheral arthritis, which causes pain, swelling, and stiffness in the joints. The pain can migrate from one joint to the next and may last for several days or even weeks. Peripheral arthritis does not cause permanent damage to joints and will often improve when the UC is successfully treated. Treatment includes resting painful joints and applying moist heat. Other forms of arthritis may also occur with UC, and may be a complication of either the disease or the medications used to treat it.
Erythema nodosum, pyoderma gangrenosum and aphthous stomatitis are skin conditions that may occur before or during a UC flare-up and improve with remission. Erythema nodosum are painful red nodules that develop on the arms or lower legs that affects more women than men. Pyoderma gangrenosum may appear as a blister on the legs or arms, usually at the site of a minor trauma such as a cut. The blister may progress into an ulcer that requires treatment with steroids or antibiotics. Aphthous stomatitis are small ulcers in the mouth and although no treatment is usually necessary, prescription mouthwashes may help keep the area clean.
