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Ulcerative colitis is a type of inflammatory bowel disease that affects the large intestine (the colon and rectum). Typically inflammation starts in the rectum and continues to other parts of the large intestine. Unlike Crohn's disease, which causes a patchy inflammation, ulcerative colitis progresses in a diffuse manner. That means the inflammation is in a continuous area.
Most symptoms are related to the inflamed rectum. The inflammation does not allow the rectum to stretch or store properly. This affects a patient's ability to sense what is in the rectum, making them feel the urgency to use the bathroom more often. Very little stool will pass during these many trips to the bathroom — sometimes just mucus and blood.
When inflammation spreads to the lower part of the intestine, people can feel paradoxically constipated. The reason for this is that the bowel above the inflammation is working fine, but when it gets to the inflamed area, it can't stretch like it is supposed to. That can cause an internal back up, causing bloating and gas.
Some people may experience extraintestinal manifestations, which refers to inflammation in other parts of their body. The most common manifestation is symmetrical joint pain, which occurs on both sides of the body, often in smaller joints. Other less common types include skin and/or liver inflammation. Extraintestinal manifestations are connected to the bowel inflammation and will get better if the inflammation in the large intestine is treated.
Although we don't know its cause, we do know a lot about how to treat ulcerative colitis. Our goal for treatment is to get patients into remission and keep them in remission forever, allowing our patients to have a very high quality life.
Ulcerative colitis inflammation is confined to the lining — or mucosa — of the large intestine. Treatment starts with medicines that treat this lining. We recommend rectal therapy in addition to oral therapy to help the medicine start working quickly. This requires a suppository, enema or foam, but will help patients feel better faster.
People who have long standing ulcerative colitis have a slightly increased risk of developing precancerous changes in the bowel. For these patients, we start doing colonoscopies after eight years to check for changes. Fortunately, advances in our technology continue to make it easier to discover and remove any abnormalities. Risk of precancerous changes is directly related to the amount of inflammation occurring in the bowel over time. Correctly diagnosing, treating and preventing ulcerative colitis is very important to reducing the risk of these complications later on.
In 1978, ulcerative colitis disrupted Tom Dabertin’s active lifestyle. Throughout his four decades of care at UChicago Medicine, Tom not only found relief, but created a festival dedicated to foods he couldn't eat prior to treatment.Read Tom's Story
For college student Jaclyn Hanley, the challenges of managing ulcerative colitis symptoms, medication side effects and multiple hospitalizations — in addition to her studies — felt miserable. After starting treatment with IBD expert David Rubin, MD, Jaclyn eventually found relief and remission.Read Jaclyn's Story
Abbie Perkovich had been sidelined by inflammatory bowel disease. Her medications were no longer keeping the disease under control. Doctors thought her best option was to have her colon (large intestine) surgically removed — a process that requires several major operations.Read Abbie's Story