According to the National Institutes of Health (NIH), approximately 600,000 to 900,000 people in the United States have ulcerative colitis – an inflammatory bowel disease that causes sensitivity, swelling and ulcers on the inner lining of the large intestine. 

“Ulcerative colitis is a chronic inflammatory condition that primarily affects the colon…[and]…the cause continues to be unknown,” says George Salem, M.D., assistant professor of medicine and director of the Crohn’s and Colitis Center at OU Health. “The symptoms, when not treated early at the time of diagnosis, tend to be progressive.”

He says patients typically begin to have rectal bleeding, stool urgency and frequency, diarrhea and mucus in stool. 

“If left untreated, patients will experience abdominal pain, generalized fatigue, anemia and poor sleep at night due to worsening diarrhea symptoms, affecting their ability to have an undisturbed sleep at night,” says Salem.

To determine that an individual has ulcerative colitis and not another inflammatory bowel disease, a patient will receive a thorough evaluation that will include taking a medical history, receiving a physical exam, and performing basic food and stool testing.  

“If the diagnosis of ulcerative colitis is suspected, performing a colonoscopy, and obtaining samples from the lining colon, is mandatory for the diagnosis to be made,” says Salem. 

He also shares that “the majority of patients are usually healthy before the time of diagnosis, as it tends to commonly affect the younger patient populations, including pediatrics and up to the age of mid-30s.”

The NIH reports that ulcerative colitis is more likely to develop in people between the ages of 15 and 30, those who have a first-degree relative, such as a parent, sibling or child with IBD, and those of Jewish descent. 

However, Salem says a diagnosis can be made later in life as well – a form of the disease known as late-onset ulcerative colitis. 

Along with the many symptoms associated with ulcerative colitis, other complications can develop such as low bone mass, slowed growth and development in children, and an increased risk of developing colorectal cancer.  The NIH states that individuals with ulcerative colitis are at a higher risk for colorectal cancer if their disease affects a greater portion of the large intestine, is more severe, began at an earlier age, or has been present for a longer time. 

In addition, inflammation can also affect other parts of the body beyond the large intestine, including the joints, skin, eyes and liver and bile ducts. People with ulcerative colitis may also have a higher risk of developing blood clots. 

For people living with an illness with no known cure, consistent daily management of the disease is essential to minimizing symptoms. 

“It can be a challenge to describe the concept of ‘treatable, manageable, but not curable’ to patients and their loved ones…[but]…patients who are on appropriate treatment usually manage symptoms well,” says Salem. “For any chronic condition, appropriate treatment options tend to control the inflammation, control symptoms and prevent long-term complications.”

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