Ulcerative Colitis

Ulcerative colitis (often just called UC) is medical speak for ulcers and inflammation in the large intestine (or colon). Along with Crohn's disease, UC is one of the Inflammatory Bowel Diseases (IBD). In adults, UC is usually milder, involving just the lower part of the large intestine. In children and teens, more of the colon is usually involved and as a result, kids with UC tend to have more symptoms.

The Symptoms

  • Abdominal Pain
  • Diarrhea
  • Intestinal bleeding
  • Anemia from the blood loss
  • Growth problems
  • Leg sores (rarely)
  • Arthritis (rarely)

Some patients just have diarrhea and bleeding without any abdominal pain. Others will have intense pain. Growth problems and arthritis can occur but those problems are more common in Crohn's disease.

The more of the large intestine that's involved, the more symptoms the patient is going to have. Because children tend to have extensive colitis more often than adults probably then explains why they tend to have a more severe course.

Ulcerative Colitis in the Small Intestine

Ulcerative colitis sometimes extends into the lower end of small intestine (the terminal ileum) as well. When it does, this is referred to as backwash ileitis. When the ileum is involved, this sometimes can make the diagnosis more difficult, because the pattern (the symptoms, location and severity) can resemble Crohn's disease, and sometimes, it becomes temporarily classified as “IBD-Undertermined,” which doesn't usually change treatment

We've even reported that, using a pill camera on patients with UC, parts of the small intestine (other than the terminal ileum) can look like they have surface resembling what we typically see in the small intestine. Some would call this Crohn's disease, since UC supposedly is localized in the large intestine, but we've elected to place it in the category of IBD-Undetermined.

Nutritional and Medical Treatment For Ulcerative Colitis

At the present time, there is no cure for ulcerative colitis, other than to remove the large intestine. While that sometimes becomes necessary, most doctors and patient-families would prefer to use their diet and one (or more) of the many medicines that are available to control their symptoms and to help heal their intestine.

However, nutritional therapy has not been as effective for UC as for Crohn's disease. As a result, enteral therapy is not used. Alternative, restrictive diets have been used with some success, particularly the Specific Carbohydrate Diet (SCD), according to those who have stuck closely to the diet for years, but scientific evidence is still lacking (though researchers are in the midst of studies to test its effectiveness).

Certain probioticshave been used with greater success for some patients. However, studies show that when these somewhat expensive medicines are used, they don't lessen hospitalizations or cost for the majority.

No matter what diet or medications are used, patients should be monitored for