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Digestive Health Digestive Health Basics

Ask Your Doctor About Ulcerative Colitis: Symptoms, Treatment and Other Risks

Ask Your Doctor About Ulcerative Colitis:
Symptoms,Treatment and Other Risks

What should I expect my life to be like now that I have been diagnosed with ulcerative colitis?

Symptoms
As its name suggests, ulcerative colitis causes ulcers or breaks in the lining of the bowel along the length of the large intestine (the colon and rectum). Symptoms of the disease may include:

• Urgency to have a bowel movement
• Diarrhea or frequent trips to the toilet, sometimes with watery bowel movements or to pass mucous or gas
• Rectal bleeding
• Blood or pus in the stool
• Straining with bowel movements
• Abdominal cramping and gas
• Feeling tired
• Loss of appetite
• Weight loss
• Anemia

The symptoms tend to come and go. This is called having “flare-ups” or “relapses” when symptoms are present and “remission” when the symptoms are treated and go away. Most people with ulcerative colitis have a milder disease characterized by uncomfortable but manageable flare-ups that alternate with months or even years of asymptomatic remission. However, some people have more severe disease with frequent attacks and more serious symptoms. It is very important to let your doctor know early if you have recurrence of symptoms or worsening of actively treated disease. Symptoms such as severe pain, fever, inability to have a bowel movement, dehydration, or having a large amount of blood or pus in your stool may require more aggressive treatments and may even require hospitalization to get it under control.

Treatment
The goal of treatment for ulcerative colitis is to bring about remission of the disease and keep patients in remission for as long as possible. The treatment depends on the severity of the disease. There are no dietary restrictions, although you will want to avoid foods that increase your symptoms when the disease is active. Some people find it necessary to avoid milk products. Alcohol and caffeine do not appear to make the disease any worse although they may cause mild symptoms, especially during relapses. A healthy diet and supplemental multivitamin is recommended.

Most of the time, the disease is treated with medications. There are several different types of drugs that are effective in treating flare-ups and maintaining remissions:

• Anti-inflammatory drugs are the first-line treatment for ulcerative colitis (examples are sulfasalazine, olsalazine, mesalamine or balsalazide).
• Corticosteroids such as prednisone are used during flare-ups, but do not bring about long-term remission and should be limited to short-term use only.
• Immunomodulators may be required to maintain remission (examples are azathioprine, 6-mercaptopurine, infliximab or cyclosporine).

It is known that chronic use of some of these medications successfully maintains remission and prevents relapse, so it is recommended that patients with ulcerative colitis stay on therapy even when they are in remission. There are some side effects associated with use of these medications, and patients should be aware of and speak to their doctor about them.

Ulcerative Colitis and the Risk of Colon Cancer
After years of disease, ulcerative colitis is associated with a rare but increased risk of developing colon cancer. It is important to know that there are a number of strategies for prevention that include periodic colonoscopies as well as possible long-term use of maintenance therapy with anti-inflammatory medications.

Although there is no medical cure for ulcerative colitis, the condition can be treated effectively and patients should expect to have a normal quality of life despite living with this disease. Patients who are fully informed about the goals of management for ulcerative colitis, the available treatment options and potential side effects, and have an effective doctor-patient relationship will be more successful at managing their ulcerative colitis.

                  
This project is supported through an educational grant from Shire Pharmaceuticals Inc.

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