Risk factors
- Age
- Race: The risk is higher among whites and Ashkenazi Jewish.
- Positive family history
- Vitamins A and E (antioxidants) deficiency
- Psychological stress
- Milk consumption
The smoking effect on ulcerative colitis is unusual. Unlike Crohn’s disease, ulcerative colitis is less common among smokers. Also, there is some evidence about the protective role of smoking in ulcerative colitis.
Diagnosis of ulcerative colitis should exclude other diseases that show similar symptoms, such as Crohn’s disease and colon cancer. Doctors have many investigations that can diagnose ulcerative colitis, exclude other conditions, and evaluate the patient’s status. Endoscopic techniques and tissue biopsies make the definitive diagnosis. Endoscopic procedures show the ulcers and determine their site. We have other tests and investigations to help the doctor to see if you have dangerous complications. Blood tests check for anemia that may occur due to rectal bleeding. Stool examination detects gut infections that have symptoms similar to ulcerative colitis. Stool examination also detects other specific proteins (calprotectin). Also, your doctor may order other serological tests to look for specific antibodies. Other tests may include barium enema, CRP, and ESR. Your doctor may need imaging techniques, such as X-ray, CT scans, and ultrasound, if the symptoms suggest serious complications, such as a perforated colon.
Ulcerative colitis has no curative medical treatment. The management plan depends on the severity of the condition and aims to relieve the symptoms as possible, help the colon heal, and reduce the frequency of attacks. The management plan involves three lines: diet modifications, medications, and surgery.
Each patient may experience worsening with some foods different from the other patients. Thus, there is no specific diet for all patients; each patient should avoid any food that worsens his/her condition. Medical treatment aims to fight the symptoms, induce remission, and maintain it. Medications include:
- Anti-inflammatory drugs, such as aminosalicylates and steroids
- Immunosuppressors, such as azathioprine and cyclosporine
- Biologics, such as infliximab
- Other medications, such as antidiarrheal drugs, antispasmodics, and analgesics
The choice of medications depends on your symptoms, type, and severity of the disease. Thus, talk with your doctor before taking or stopping any medication.
If the previous options didn’t control the disease or give the desired outcome, surgery would be the choice. Surgery may remove the entire colon and rectum, which cures ulcerative colitis, but it has risks and impacts on your life that your doctor should discuss with you. Surgery may be urgent or elective.
In this article, we will answer -in detail- the following questions about ulcerative colitis:
- What is the clinical picture of ulcerative colitis?
- What are the effective treatment options that can control this disease and improve the quality of life?