Ulcerative Colitis
Ulcerative colitis, a type of inflammatory bowel disease (IBD), is one of the two primary forms of this condition, the other being Crohn’s disease. Both ulcerative colitis and Crohn’s disease are chronic diseases that persist throughout a person’s life. It’s important to note that inflammatory bowel disease is distinctly different from irritable bowel syndrome (IBS), which affects bowel function without causing inflammation. Ulcerative colitis typically affects individuals across various age groups, with onset commonly occurring between the ages of 15 and 30. It is also notably observed in individuals aged 50 to 70. A family history of ulcerative colitis can increase the risk of other family members developing the disease. Distinguishing between ulcerative colitis and Crohn’s disease can sometimes be challenging, especially in the early stages, due to the similarities in symptoms. The primary distinction is that ulcerative colitis affects only the inner lining of the colon, while Crohn’s disease can impact the entire bowel wall. Ulcerative colitis specifically targets the large intestine, including the colon and rectum, whereas Crohn’s disease can occur anywhere in the gastrointestinal tract from the mouth to the anus.
Symptoms of Ulcerative Colitis
The signs and symptoms of ulcerative colitis can vary based on the severity of the disease and its location. Common symptoms include ulceration of the colon lining, blood in the stool, abdominal pain and cramps, diarrhea, and a persistent urgency to have a bowel movement despite the lack of stool, known medically as tenesmus. Other symptoms may include fever, decreased appetite, and the presence of mucus in the stools. Ulcerative colitis is a progressive disease, which means that ulcers can begin in the lower part of the colon and subsequently spread to other areas. The various forms of ulcerative colitis and their typical symptoms include:
- Ulcerative Proctitis: This type is limited to the rectum, causing diarrhea, bloody stools, rectal pain, and tenesmus.
- Proctosigmoiditis: This form affects both the rectum and the sigmoid colon, leading to diarrhea (particularly bloody), rectal pain, and pain in the lower left abdomen.
- Left-Sided Colitis: Also known as distal colitis, it impacts the left side of the colon, involving the rectum, sigmoid colon, and descending colon. Symptoms include diarrhea, bloody stools, weight loss, reduced appetite, and severe pain on the left side.
- Pancolitis: This type affects the entire colon, resulting in diarrhea, cramps, significant weight loss, and severe abdominal pain.
Complications of Ulcerative Colitis
Ulcerative colitis can lead to various complications both within the gastrointestinal tract and beyond, including:
- Gastrointestinal Complications:
- Perforated Colon: This emergency condition causes severe bleeding and abdominal pain.
- Fissure: This refers to a tear in the anal canal lining, potentially leading to pain and bleeding.
- Toxic Megacolon: A rare but serious condition that results in extreme dilation of the colon and requires urgent treatment.
- Colon Cancer: The risk of developing colon cancer increases after 8 to 10 years of having ulcerative colitis.
- Extraintestinal Complications:
- Delayed Growth in Children: Certain older medications for ulcerative colitis and the malnutrition caused by the disease can lead to growth issues in children.
- Eye Disorders: Ulcerative colitis may lead to iritis, glaucoma, keratitis, and dry eyes.
- Joint Inflammation: Joint-related complications are among the most common outside of the digestive system, encompassing various types of arthritis such as peripheral arthritis, axial arthritis, rheumatoid arthritis, and ankylosing spondylitis.
- Skin Disorders: Conditions like erythema nodosum, pyoderma gangrenosum, and psoriasis may occur more frequently in individuals with ulcerative colitis.
- Oral Ulcers: This condition can cause aphthous stomatitis, characterized by sores in the oral mucosa.
- Menstrual Symptoms: Some women with inflammatory bowel disease report generalized worsening of diarrhea and pain during premenstrual syndrome (PMS).
Dietary Recommendations for Ulcerative Colitis
Research has not conclusively shown that specific dietary habits cause ulcerative colitis symptoms; however, maintaining good nutrition is essential during treatment. Dietary modifications can alleviate some symptoms. Recommended dietary practices for individuals with ulcerative colitis include:
- Avoiding carbonated beverages.
- Limiting popcorn, fibrous plant skins, nuts, and other high-fiber foods, particularly during flare-ups.
- Increased fluid intake.
- Consuming small, frequent meals.
- Keeping a food diary to identify problematic foods.
- Following a specialized diet tailored to individual symptoms and medications, which may include:
- A high-calorie, low-lactose, low-fat, low-fiber, and low-salt diet.