Ulcerative colitis – different types, causes and associated symptoms

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ulcerative colitis symptoms causes

Ulcerative colitis is IBD (inflammatory bowel disease) that is causing long – lasting inflammation and ulcers (sores) in the digestive tract. This condition is affecting the innermost lining of the large intestine, colon, and the rectum. Symptoms of ulcerative colitis develop over time, rather than suddenly. This condition can be debilitating and in some cases it can lead to life – threatening complications. There is not known cure for ulcerative colitis but the treatment can help to reduce its signs and symptoms and it can bring about long – term remission.

Ulcerative colitis symptoms

Symptoms of ulcerative colitis can vary which depends on the severity of the inflammation and where it happens. Here are some signs and symptoms of ulcerative colitis:

  • Fever
  • Fatigue
  • Weight loss
  • Inability to defecate despite urgency
  • Urgency to defecate
  • Rectal bleeding – passing small amount of blood with stool
  • Rectal pain
  • Abdominal pain and cramping
  • Diarrhea, often with blood or pus
  • In children, failure to grow

Ulcerative colitis causes

The exact cause for ulcerative colitis is still not known. In the past doctors were suspecting on stress and diet but nowadays doctors know that they can aggravate but not cause this condition. An immune system malfunction is one possible cause for ulcerative colitis [1]. When your immune system is trying to fight off an invading bacterium or virus, then the abnormal immune response causes the immune system to attack the cells in the digestive tract. Also there are some studies in which are said that heredity can play a role in this condition and it is more common in people who have family members with ulcerative colitis [2,3]. But in the most cases people who suffer from ulcerative colitis do not have family history of ulcerative colitis.

Risk factors: This condition affects about the same number of men and women. Here are some factors that can increase the risk of ulcerative colitis:

  • Family history: If you have a close relative, such as a parent, sibling or child who suffers from ulcerative colitis, then you have higher risk of getting it. [3]
  • Race or ethnicity: There are some studies in which are said that white people have the biggest chances of getting ulcerative colitis but it can happen in any race. If you are of Ashkenazi Jewish descent, then your risk of getting this condition is even higher. [4]
  • Age: This condition is usually happening before the age of 30. But ulcerative colitis can happen on any age and there are some people who will not develop this disease until after age 60. [5]

ulcerative colitis symptoms causesTypes: Doctors usually classify this disease according to its location. Here are some types of ulcerative colitis:

  • Acute severe ulcerative colitis: This is a rare form of colitis which is affecting the entire colon and it can cause inability to eat, fever, bleeding, profuse diarrhea and severe pain.
  • Pancolitis: This condition often affects the entire colon and it is causing bouts of bloody diarrhea which can be severe, significant weight loss, fatigue, abdominal cramps and pain.
  • Left – sided colitis: This is a type of ulcerative colitis in which inflammation is extending from the rectum up through the sigmoid and descending colon. Signs and symptoms of this type of ulcerative colitis include unintended weight loss, abdominal cramping and pain on the left side and bloody diarrhea.
  • Proctosigmoiditis: The inflammation is involving the rectum and the sigmoid colon – the lower end of the colon. Signs and symptoms of this type of ulcerative colitis are including an inability to move the bowels in spite of the urge to do so (tenesmus), abdominal cramp and pain and bloody diarrhea.
  • Ulcerative proctitis: The inflammation is confined to the area which is closest to the anus, rectum, and the rectal bleeding can be the only sign of this type of ulcerative colitis. This type of ulcerative colitis is the mildest form of it.

Complications: Here are some complications of ulcerative colitis  [6,7] which can happen:

  • Increased risk of blood clots in veins and arteries
  • A rapidly swelling colon (toxic megacolon)
  • An increased risk of colon cancer
  • Inflammation of your skin, joints and eyes
  • Bone loss (osteoporosis)
  • Liver disease (rare)
  • Severe dehydration
  • A hole in the colon (perforated colon)
  • Severe bleeding

References:

[1] Dave M, Papadakis KA, Faubion WA. Immunology of inflammatory bowel disease and molecular targets for biologics. Gastroenterology Clinics of North America. 2014;43(3):405–24.

[2] Wellcome Trust Sanger Institute. Largest genetic study of inflammatory bowel disease provides clues on new drug targets: Scientists identify genetic variant that doubles an individual’s risk of developing ulcerative colitis. Science Daily. 2017. Retrieved from www.sciencedaily.com/releases/2017/01/170130092056.htm

[3] Childers RE, Eluri S, Vazquez C, et al. Family history of inflammatory bowel disease among patients with ulcerative colitis: A systematic review and meta-analysis. Journal of Crohn’s and Colitis. 2014;8(11):1480-97.

[4] Basu D, Lopez I, Kulkarni A, Sellin JH. Impact of race and ethnicity on inflammatory bowel disease. American Journal of Gastroenterology. 2005;100(10):2254-61.

[5] Zammarchi I, Lanzarotto F, Cannatelli R, et al. Elderly-onset vs adult-onset ulcerative colitis: a different natural history? BMC Gastroenterology. 2020.

[6] Manser CN, Borovicka J, Seibold F, et al. Risk factors for complications in patients with ulcerative colitis. United European Gastroenterology Journal. 2016;4(2):281–7.

[7] Fradet C, Kern J,Atanasov P, et al. Impact of surgery and its complications in ulcerative colitis patients in clinical practice: A systematic literature review of real-world evidence in Europe. International Journal of Surgery Open. 2020;22:22-32.

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