Ulcerative colitis is an inflammatory bowel disease that affects people of all ages. However, most people diagnosed with this condition are between 15 and 35 years of age. According to reports, it has been estimated that about one million people in the United States are affected by ulcerative colitis, making it three times more common than Crohn’s disease, another inflammatory bowel condition. Let’s have a look at this disease in detail.

Disease overview
A bowel condition that results in inflammation and ulcers or sores in the digestive tract is known as ulcerative colitis. It affects the innermost lining of the large intestine and rectum. Symptoms of this condition develop slowly over time. This condition is classified depending on where it occurs or the region of the large intestine that it affects. Ulcerative colitis can be divided into the following types.

• Ulcerative proctitis – Rectal bleeding is the only symptom of this type of ulcerative colitis. The inflammation that occurs in this type is in the area close to the rectum.
• Proctosigmoiditis – In this type, inflammation occurs in the rectum and the lower end of the colon, also known as the sigmoid colon.
• Left-sided colitis – Inflammation occurs from the rectum and affects the sigmoid and descending colon in this type of ulcerative colitis.
• Pancolitis – This type of ulcerative colitis affects the entire colon and causes bouts or episodes of bloody diarrhea that could be severe.

Symptoms
The signs and symptoms of ulcerative colitis depend on the severity of the inflammation and where it occurs in the large intestine. The main symptoms of the condition are:

• Bloody diarrhea
• Pus (also be present in the stool)

Other signs and symptoms that could be indicative of this condition are:

• Stomach cramps
• Loss of appetite
• Sudden urge to pass stool
• Feeling like you have not finished passing stool even though you have just used the toilet
• Inability to control your urge to pass stool
• Pain or bleeding during bowel movements
• Waking up at night because you feel like using the toilet
• Weight loss
• Tiredness
• Dehydration
• Fever
• Sore joints or pain in the joints
• Pain in the eyes when looking at bright light
• Anemia or a deficiency of red blood cells in the body
• Sores or canker sores in the mouth and on the skin

When diagnosed in children, ulcerative colitis could have an impact on the growth rate. It should be noted that symptoms can flare up or subside and then return sometimes even after weeks or years.

Causes
The exact cause of ulcerative colitis remains unknown, however, the factors that could trigger the condition in some people are:

Genes
Experts have found some abnormal genes in people with this condition. Therefore, you could have inherited a gene that causes ulcerative colitis from your parents.

Immune system infections
An infection of the immune system that does not subside or go away could result in inflammation of the colon and this, in turn, could result in the symptoms of ulcerative colitis.

Other factors

• Germs in the environment that increases your risk of developing conditions such as ulcerative colitis.
• Stress and emotional distress can act as triggers for this condition.
• Certain medications such as nonsteroidal anti-inflammatory drugs, birth control pills, and antibiotics could increase your risk of developing ulcerative colitis.
• Consuming a diet rich in fats and certain kinds of foods can trigger symptoms of the condition.

It should be noted that certain factors such as those mentioned below could also put you at risk of developing this condition:

• Age
  Although ulcerative colitis can affect people of any age, it is usually diagnosed before the age of 30. However, some individuals may not develop the condition till 60 years of age.
• Family history
  If a close member of your family, such as a parent, sibling or child has been diagnosed with ulcerative colitis, your risk of developing the disease increases.

Treatment options
The treatment for ulcerative colitis aims at trying to make the patient feel better and preventing a flare-up of symptoms. Certain forms of treatment could also help the colon to heal. Some of the treatment options recommended for this condition are:

• Diet
  Certain foods can act as triggers causing a flare-up of the symptoms, aggravating your condition. Spicy and fiber-rich foods should be avoided. Also, if you are unable to digest the sugar known as lactose that is present in milk or are lactose intolerant, you should avoid milk and dairy products such as cheese and butter. Eating a balanced healthy diet rich in fruits, vegetables, and lean proteins that provide your body with the essential nutrients that it requires is recommended.
• Medication
  Some of the medicines that could be prescribed by your doctor to help treat ulcerative colitis are:
  • Antibiotics
    These help fight infections, allowing your intestine to heal.
  • Aminosalicylates
    Also known as 5-aminosalicylic acid or 5-ASA, these medicines help reduce inflammation and soothe the symptoms of ulcerative colitis. These are available in the form of pills or can be administered as an enema or suppository.
  • Corticosteroids
    If your symptoms are severe and aminosalicylates are not able to provide relief, you could be prescribed these anti-inflammatory medicines for a short while.
  • Immunomodulators
    This medication could take up to three months to take effect and show results. It helps stop the attack by the immune system on the colon.
  • Biologics
    In severe cases of ulcerative colitis, these medicines made from proteins in living cells are advised.
  • Loperamide
    This medicine can help slow or stop diarrhea and is available over-the-counter. However, you should consult your doctor before taking it, especially if you have been diagnosed with digestive issues like ulcerative colitis.
• Surgery
  If the treatment options mentioned above are not effective or if your condition is severe, your doctor could advise surgery. Procedures like a colectomy (colon removal) or a proctocolectomy (colon and rectum removal) could be performed. If the latter procedure is performed, then a pouch known as the ileal pouch-anal anastomosis or IPAA is formed using the small intestine. This is attached to the anus to allow the body to get rid of waste normally.

Although there is no known cure for ulcerative colitis, the treatment options available can reduce the severity of signs and symptoms and make the condition manageable. In some cases, ulcerative colitis can result in life-threatening complications, and hence, seeking timely treatment is essential. A doctor would be able to recommend the best treatment option for your condition.

Natural remedies
Some of the natural remedies for ulcerative colitis are listed below.

• Bromelain
  This is a type of enzyme found in pineapples. It is also available as a supplement. It can help soothe the symptoms of ulcerative colitis and reduce the occurrence of flare-ups.
• Probiotics
  Found in yogurt and other fermented foods, these help boost the health of the bacteria in the gut or the good bacteria. The bacteria found in the stomach and intestines help the body fight inflammation and prevent ulcerative colitis symptoms. Probiotics are also available in the form of supplements.
• Boswellia
  This is an herb found in tree bark, and according to studies, it can help prevent the occurrence of certain chemical reactions in the body that result in inflammation.
• Turmeric
  This yellow spice is packed with beneficial properties and is widely used in a number of natural remedies. It contains an antioxidant known as curcumin, which has been proven to be effective in reducing inflammation.
• Dietary changes
  Consuming several small meals rather than three large ones in a day could help resolve digestive issues. Consuming a low fiber diet and avoiding the consumption of greasy and buttery foods could also be beneficial. Those who are lactose intolerant should avoid milk and dairy products to prevent a flare-up of symptoms. Consult your doctor if you need to take calcium or vitamin D supplements. Most people diagnosed with ulcerative colitis are not able to absorb and process these nutrients, which results in bone loss.

Even though some of the natural remedies listed above can be used along with other ulcerative colitis treatment options, it is advisable to consult your doctor before you start any of them.

Foods to have
A few of the best foods to include in your diet if you have been diagnosed with ulcerative colitis or are experiencing flare-ups are:

• Applesauce
  Soft, easily digestible foods like applesauce are a good choice when your gastrointestinal system is inflamed. However, opt for the unsweetened variety as sugar can aggravate your condition further. You can also make your own sugar-free applesauce at home by cooking peeled and sliced apples in water. Cool and then grind the apples to make a puree.
• Ripe bananas and canned fruit
  Bananas are rich in carbohydrates, protein and fats and provide your body with the nutrients and energy it requires. Also, soft canned fruits such as pears or peaches are easy to digest and would not irritate your intestinal lining.
• Cooked vegetables
  Vegetables are a powerhouse of vitamins and minerals. However, when you have been diagnosed with a condition such as ulcerative colitis, it is best to ensure that the vegetables you consume are thoroughly cooked and can be easily mashed with a fork. This is especially important if you are going through a flare-up of symptoms. Cooking vegetables thoroughly ensures that the fiber in them is broken down, making them easy to digest.
• Yogurt
  Yogurt is a good source of probiotics and can help soothe the symptoms of digestive issues such as ulcerative colitis. Check the label of the product that you wish to buy to ensure that it contains live and active cultures, which are very beneficial. Avoid products with large pieces of fruit that are difficult to digest or contain high sugar. If you are lactose intolerant, you can try other fermented foods such as kimchi and sauerkraut, which are also rich in probiotics. These can easily be added to scrambled eggs or tacos.
• Salmon
  Fatty fish like salmon is a great source of protein and contains healthy omega-3 fatty acids that could help reduce inflammation and provide relief from the symptoms of this condition. However, cook the fish by baking, broiling, or sautéing. Avoid frying the fish as most of its nutrients will be lost.
• Water
  During a flare-up of ulcerative colitis, the most common symptom is diarrhea. To prevent dehydration caused due to the passing of frequent watery stool, it is essential that you drink plenty of water and fluids. You can also have fruit juices that have little or no fruit pulp in them and those with reduced sugar. However, it is best to avoid prune juice due to its high fiber content. Sport drinks diluted with water can also help replenish the water and electrolytes that have been lost due to diarrhea.

It is important to know the foods that can trigger your symptoms and aggravate your condition. Avoiding certain trigger food items should help you manage your condition more effectively. Even though ulcerative colitis is a chronic condition, you can manage and cope with it better with proper treatment. Also, seeking treatment will help you avoid complications such as a perforated colon and colon cancer that could result from this inflammatory bowel disorder.