Hi, it's Cathy with Level Up RN. In this episode of Ask a Nurse, I'll be answering your questions about ulcerative colitis, such as, what is ulcerative colitis? What are the signs and symptoms of ulcerative colitis? And how is ulcerative colitis diagnosed and treated? Ulcerative colitis is a chronic inflammatory bowel disease that causes inflammation and the development of ulcerations, which are open sores, in the large intestine. Most individuals with ulcerative colitis have periods of exacerbations or flares when symptoms are present and periods of remission when symptoms disappear. Most experts believe that ulcerative colitis is caused by an abnormal immune system response. So normally, the immune system is supposed to protect you from infection. However, with ulcerative colitis, the immune system overreacts and causes damage to healthy tissue in the colon. Other factors that play a role in the development of ulcerative colitis include genetics, the microbiome in your digestive tract, which are the bacteria, viruses, and fungi that reside in your intestine, and environmental factors such as stress, diet, and pollution. Symptoms of ulcerative colitis include diarrhea, blood and/or mucus in the stool, abdominal pain and cramping, and a constant urge to have a bowel movement. More severe cases of ulcerative colitis can cause nausea and vomiting, fatigue, weight loss, fever, and anemia due to blood loss.
To diagnose ulcerative colitis, your provider will obtain information about your medical history, family history, and symptoms and perform a physical exam. Blood work will be ordered to check for anemia as well as the presence of any infection that may be causing your symptoms. A stool test will also be ordered to check for inflammation and infection in your intestines. And finally, an endoscopy and biopsy is used to definitively diagnose ulcerative colitis. It is also used to determine how much of the colon is affected and the severity of the disorder. So during this procedure, a thin long tube with a light and camera on the end is inserted into the anus to examine the rectum and large intestine. A biopsy is obtained by removing a very small piece of tissue from the inside of the large intestine. And after the procedure, this tissue is analyzed by a pathologist.
In terms of treatment, there is no cure for ulcerative colitis, but there are a number of medications that can help decrease inflammation in the colon. Mild to moderate ulcerative colitis is often treated with an aminosalicylate, such as mesalamine or sulfasalazine. For moderate to severe ulcerative colitis, a corticosteroid, such as prednisone, may be prescribed. Of note, steroids have very serious side effects, so these medications are recommended for short-term use only. And they need to be tapered down gradually once symptoms are controlled. Other medications used for moderate to severe ulcerative colitis include immunosuppressants and biologics to help keep ulcerative colitis in remission. Changes in diet can also help to reduce symptoms of ulcerative colitis, and I would highly recommend working with a dietitian who specializes in nutrition for inflammatory bowel disease. Recommendations are often focused on consuming a nutrient-dense diet and limiting foods that trigger symptoms, such as high-fiber and high-fat foods, foods that contain lactose, sugary foods and beverages, as well as alcohol and caffeine. In addition, many people have a reduction in symptoms when they consume smaller, more frequent meals.
Surgery may be required if medications are ineffective, if colorectal cancer is present, or there is a life-threatening complication present, such as severe rectal bleeding. Surgery for ulcerative colitis involves the removal of the rectum and large intestine, which is called a proctocolectomy. In one type of surgery, an internal pouch is created from the end of the small intestine and is attached to the anus. Following this type of surgery, stool will continue to pass through the anus. In another type of surgery, the end of the small intestine is attached to an opening in the abdomen called a stoma. After this type of surgery, stool will pass through the stoma into an ostomy pouch, which is attached outside the body.
All right. That is it for this episode of Ask a Nurse. I hope it was helpful. If so, be sure to hit that like button. And if you have a health topic or question you'd like me to address in a future episode of Ask a Nurse, be sure to leave that in the comments. Stay informed and stay well.
