Ulcerative Colitis: What Kind of Disease Is It, Signs and Diagnosis

The diagnosis of "ulcerative colitis" sounds frightening, especially in the first month, when a person does not yet understand what kind of disease this is. Let us break it down without panic and without marketing fog: what exactly becomes inflamed, why colitis is called nonspecific and autoimmune, which signs are concerning, and how the diagnosis is confirmed.

What ulcerative colitis is

Ulcerative colitis is a disease in which the mucous membrane of the rectum and colon becomes inflamed and covered with ulcers. It belongs to the group of inflammatory bowel diseases. Inflammation almost always starts in the rectum and extends upward continuously, without "healthy gaps," and the rectum is always involved.

The disease can begin at any age, but more often it starts between the ages of 15 and 30. Prevalence is 35–100 cases per 100,000 inhabitants, that is, less than 0.1% of the population. In about half of people, symptoms are mild, and the course is wavelike: remission is replaced by an exacerbation that lasts from several days to several months.

Why colitis is called nonspecific and autoimmune

Ulcerative colitis is also called nonspecific ulcerative colitis (NUC). It is a chronic autoimmune inflammatory disease of the colonic mucosa that arises from the interaction of genetic factors and environmental factors and runs with exacerbations.

Possible causes and risk factors

The exact cause is unknown. Genetic predisposition is discussed: having relatives with ulcerative colitis or Crohn's disease increases the risk, and the disease tends to occur in families. The role of bacteria and viruses is not fully clear. Among environmental factors, the most studied are oral contraceptive use, smoking, and diet.

Possible triggers of exacerbation include stress, infections, changes in medication use, some painkillers (NSAIDs), and certain foods, but these are specifically triggers of exacerbation, not proven causes of the disease; sometimes there is no obvious trigger.

Main symptoms

The most common are: diarrhea, sometimes with blood, mucus, or pus; abdominal pain, more often in the left lower part, which may ease after a bowel movement; frequent and urgent urges, trips to the toilet at night; a feeling that one has gone but the bowel is empty; blood from the anus; bloating.

There may be constipation, pronounced fatigue, decreased appetite and effortless weight loss, temperature from 37 to 39 °C. During exacerbation, extraintestinal manifestations are added: painful or swollen joints, red and painful areas of skin (erythema nodosum), red itchy eyes, mouth ulcers.

How ulcerative colitis is diagnosed

The diagnosis is made by a gastroenterologist, usually in a hospital. Until a biopsy is obtained, the diagnosis is considered preliminary.

• blood test: signs of inflammation (leukocytes, platelets, ESR, C-reactive protein) and anemia;
• stool test: blood admixture, fecal calprotectin — during exacerbation it is above 100–150;
• imaging: X-ray, CT, or ultrasound;
• colonoscopy with examination of the ileum and mucosal biopsy.

At the same time, "look-alikes" are excluded: acute intestinal infections, amebiasis, helminthic infestations, Crohn's disease, colon cancer — negative tests for infections are needed.

Complications and when to see a doctor

The disease rarely threatens life, but a severe exacerbation may require emergency care in a hospital. Complications include anemia, deficiency of vitamins and minerals due to impaired absorption, delayed growth and maturation in children, and an increased risk of colon cancer.

If symptoms resemble those described, go to a doctor rather than waiting for it to resolve on its own. A visit should be expedited with very severe diarrhea or diarrhea with blood, high temperature, rapid pulse, or inability to pass gas or have a bowel movement.

Ulcerative colitis by itself is not a reason to call an ambulance; 103 or 112 — if abdominal pain has become severe, bleeding from the anus does not stop, there is a lot of blood or large clots in the stool, vomiting of blood has begun, or the vomit is coffee-ground colored.

This material is for reference and does not replace consultation with a doctor: it is better to discuss symptoms and diagnosis with a gastroenterologist, not with a search engine.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer