Ulcerative colitis is a condition that causes inflammation and ulceration of the large intestine (or large bowel) which consists of the colon and rectum. It affects only the inner-most lining of these areas. The inflammation can cause redness, pain and swelling. Colitis can also cause ulcers to develop on the surface of the bowel lining, which can bleed and produce mucus.
The role of the digestive system, or gut, is to digest the food we eat so the body can absorb its nutrients. After leaving the stomach, partly digested food enters the small intestine where it is broken down further and nutrients are absorbed into the bloodstream. The leftover waste consists of liquid and undigested food, which pass into the colon. The undigested food is excreted as a bowel movement and the liquid is absorbed by the colon.
Patients with ulcerative colitis
In patients with ulcerative colitis, parts of the colon or rectum are inflamed. Inflammation usually occurs in response to an infection, and the body naturally sends white blood cells to the area to fight the infection. The inflammation caused by ulcerative colitis can interrupt the guts normal function and it is less likely to absorb this leftover liquid. This results in a large volume of watery stools. As the colon cannot hold as much waste as normal, it can also cause very frequent bowel movements, as many as six or more a day. Ulcerative colitis can also cause the formation of ulcers on the colon lining which can bleed and produce mucus, which is then excreted with stools.
Types of ulcerative colitis
There are three main types of ulcerative colitis and they are categorised according to which part of the large intestine is affected:
Affects only the rectum. As the rest of the colon is unaffected, the main system is usually passing blood in stools, or an increased urge to go to the toilet.
Left-sided (or distal) colitis
Affects the rectum and the left-side of the colon. Symptoms include diarrhoea with blood and mucus, pain on the left side of the abdomen and an urge to go to the bathroom.
Total colitis or Pancolitis
Affects the whole colon. As inflammation is extensive, symptoms include very frequent diarrhoea with blood and mucus, severe abdominal cramps, pain, fever and weight loss.
Living with ulcerative colitis
Living with ulcerative colitis affects each patient differently. The impact it may have on a patient’s life will depend on the severity of their disease and whether they are in a period of remission, when the disease is less active and easier to manage, or in an active phase (known as a flare-up), when effects can be more severe. Most people follow patterns of remission and infrequent periods of active disease. In remission, symptoms are controlled by medication, so patients are able to live their lives in a normal way but experience mild and infrequent diarrhoea and pain. During flare ups when wind, diarrhoea and bloating aren’t well controlled by medication, quality of life is compromised.