Ulcerative colitis treatment

Ulcerative colitis is a chronic disease that creates inflammation and ulcers in the lining of the colon. It can cause severe episodes of cramping and diarrhoea, which can be painful, stressful and disruptive.

While there is no cure for ulcerative colitis, there are treatments available that make it possible to manage the disease and prevent flare-ups. A gastroenterologist can support you in finding an effective pattern of treatment with the aim of creating longer periods of remission.

What is ulcerative colitis?

Ulcerative colitis is the most common form of inflammatory bowel disease. As its name suggests, this type of inflammatory bowel disease creates small ulcers on the lining of the colon. It differs from Crohn’s disease because it typically affects the rectum and colon, rather than the entire gastrointestinal tract.

What are the symptoms of ulcerative colitis?

One of the most common symptoms of ulcerative colitis is diarrhoea (which can be bloody). Some patients experience abdominal pain and frequent bowel movements. Other symptoms can include tiredness, fever, weight loss, joint pain and skin rashes.

People with ulcerative colitis may find that they experience ‘flare-ups’ followed by periods of ‘remission’ when their symptoms are not as severe.

What causes ulcerative colitis?

The exact cause of ulcerative colitis is unknown, but it’s thought that genetics, the microbiome of the gut and the environment (smoking, pollution, diet etc.) may be factors.

Some experts believe that ulcerative colitis may be caused by an issue with the immune system. The theory is that the immune system mistakes the friendly bacteria in the colon for an infection (an autoimmune disease) or fails to recognise when a previous infection has cleared. The immune system continues to react and cause inflammation even though there is no infection.

Although it can be diagnosed at any age, most people with ulcerative colitis are diagnosed before they turn 30.

When to speak to a consultant

If you are experiencing the symptoms of ulcerative colitis, it’s important to speak to your GP, as the condition can lead to further complications if left untreated.

If your GP suspects that you have inflammatory bowel disease, they may refer you to a gastroenterologist.

A gastroenterologist is a doctor who specialises in digestive disorders. They will be able to use more advanced tests to investigate your symptoms and support you in establishing a treatment plan.

Diagnosing and treating ulcerative colitis

If you are experiencing the symptoms of ulcerative colitis, it’s important to get the condition under control. This is likely to mean seeking support from a consultant gastroenterologist, who can perform further tests and recommend a treatment plan for you.

What happens during an appointment with a consultant?

When you book an appointment with Sulis Hospital Gastroenterology Unit, you’ll be welcomed into a light and airy hospital designed to make patients feel as comfortable as possible.

Your consultant will want to review your GP records and any test results before getting to know more about your symptoms and experience. They may then send you for further tests, which might include a CT scan, X-ray, sigmoidoscopy or colonoscopy.

What is a colonoscopy?

A colonoscopy is a test that enables a consultant to look inside your colon (large intestine). It is a type of endoscopy that involves inserting a long, thin, flexible tube with a camera inside it into the rectum. At Sulis Hospital, we have a specialist JAG-accredited endoscopy service, which ensures you experience the highest standards of safety and care during your examination.

Before the procedure, you will be offered laxatives to empty your bowels. You may also be given a sedative to help relax you on the day. In addition to taking a closer look at your colon, it is possible to take biopsies during a colonoscopy.

What is a sigmoidoscopy?

The sigmoid colon is the lower part of the large intestine. A sigmoidoscopy is like a colonoscopy, but it is focused on the lower half of the colon (it doesn’t go in as far). In addition to taking a closer look at what might be causing your symptoms, it may be possible to take biopsies from the area during the procedure.

What treatments are available for ulcerative colitis?

Ulcerative colitis is a chronic condition, but there are treatment options available that may help to reduce inflammation during flare-ups and help you to maintain ‘remission’ (periods without symptoms). Treatments include anti-inflammatories, aminosalicylates (5-ASAs), corticosteroids and immunosuppressants.

What if I experience a severe flare-up?

If you experience a severe flare-up of ulcerative colitis, you may need to be treated in hospital. This is due to complications that can occur, such as dehydration and damage to the colon (rupture). While in hospital, you may be given medication intravenously.

Is it possible to have surgery for ulcerative colitis?

Surgery may be an option for those patients who have experienced complications due to colitis or if the available medicines aren’t reducing your symptoms.

A colectomy is the removal of either all or part of the colon. The function of the colon is then replaced with a bag (ileostomy), or an internal pouch is created using the small intestine (ileoanal pouch). A colectomy is usually an elective procedure, and you would need to discuss the risks and potential benefits of the surgery with your consultant.