Ulcerative Colitis: Symptoms, Causes, and Treatment

By: dr. Hadi Winoto, Sp.B-KBD

Ulcerative colitis is a chronic inflammatory disease that affects the lining of the colon and rectum. This condition is a type of Inflammatory Bowel Disease (IBD).

Unlike regular diarrhea, ulcerative colitis can cause bloody stools, severe abdominal pain, and disrupt daily activities. Early detection and appropriate treatment are crucial to prevent complications.

What Is Ulcerative Colitis?

Ulcerative colitis is an autoimmune disease. Normally, the immune system protects the body from bacteria and viruses. In people with ulcerative colitis, the immune system mistakenly attacks healthy cells in the colon wall. This results in inflammation and open sores, or ulcers, that don't heal. This disease is chronic and lifelong. However, symptoms can be controlled so that sufferers can resume normal activities.

What Are the Symptoms of Ulcerative Colitis?

Symptoms of ulcerative colitis are often mistaken for hemorrhoids or regular diarrhea. However, the symptoms are more severe and last longer. Some symptoms to watch out for:

1. Bloody or mucousy stools: This is the most common sign. The blood can be bright red or dark red.
2. Persistent diarrhea: Increased frequency and urgency of bowel movements.
3. Abdominal pain and cramps: Especially in the lower left abdomen.
4. Weight loss: Due to impaired nutrient absorption.
5. Weakness and anemia: Due to chronic blood loss.

If you experience bloody stools for more than two weeks, don't delay seeing a doctor.

What Causes Ulcerative Colitis?

The exact cause is unknown. However, several factors are thought to play a role:

1. Autoimmune factors: The immune system attacks the gut itself.
2. Genetic factors: A family history of IBD increases the risk.
3. Environmental factors: Diet, stress, and exposure to certain bacteria can trigger it.
4. Gut bacterial imbalance: An abnormal composition of the gut microbiota.

It's important to remember that spicy foods or stress aren't the primary causes. However, both can trigger a relapse or flare.

How Does the Disease Progress?

Ulcerative colitis has a "wake-and-fall" pattern. There are two main phases:

1. Remission: A period when symptoms subside or disappear. Patients can resume normal activities.
2. Exacerbation/Relapse: A period of relapse with severe symptoms returning. This phase is like a roller coaster.

Without treatment, persistent inflammation can damage the intestines and lead to complications.

What Are the Possible Complications?

Early detection can prevent serious complications such as:

1. Severe intestinal bleeding
2. Perforation, or a hole in the intestinal wall
3. Toxic megacolon, a dangerous dilation of the colon
4. Increased long-term risk of colorectal cancer
5. Osteoporosis due to impaired calcium absorption

How to Treat Ulcerative Colitis?

Ulcerative colitis cannot be completely cured. The goal of treatment is to control inflammation and prolong remission. Treatment is performed by a specialist in internal medicine/gastroenterology. Some therapy options include:

1. Anti-inflammatory drugs: Such as 5-ASA to reduce mild inflammation.
2. Corticosteroids: To treat acute flares.
3. Immunosuppressants: To suppress immune system overactivity.
4. Biological therapy: Targeted drugs for moderate to severe cases.
5. Surgery: Performed if medications are ineffective or if complications arise.

In addition to medication, your doctor will also recommend a balanced diet and stress management.

When Should You See a Doctor?

Consult your doctor immediately if you experience:

1. Bloody stools for more than 3 days
2. Diarrhea more than 10 times a day
3. Severe abdominal pain that doesn't go away
4. High fever and drastic weight loss

Fast treatment makes treatment results better. Don't ignore the symptoms of bloody stools and abdominal pain. Consult your complaint to the nearest digestive surgery specialist for proper diagnosis and treatment.

FAQs

Is ulcerative colitis the same as hemorrhoids?
Not the same. Hemorrhoids are swollen blood vessels in the anus. Ulcerative colitis is inflammation of the large intestine. But both can cause bloody stools, so a doctor's diagnosis is important.

Can ulcerative colitis be completely cured?
There is no medicine that cures it completely. But with routine treatment, many sufferers can go into remission for years and live a normal life.

What foods should be avoided?
There are no standard dietary restrictions. Everyone has different triggers. Note the foods that cause symptoms to recur, then consult a nutritionist.

Is ulcerative colitis contagious?
No. This disease is not transmitted from person to person.

Can ulcerative colitis cause cancer?
The risk of colorectal cancer is indeed higher in long-term ulcerative colitis. Therefore, it is important to carry out routine colonoscopy screening according to doctor's recommendations.
 

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