By Dr. Brian Bressler and Emily Panetta

Inflammatory Bowel Disease

Many people pay no mind to the digestive process; they eat their food, go about their day, eat sleep and repeat. But for the 1 in 100 Canadians dealing with inflammatory bowel disease (IBD), the digestive process is anything but quick and painless.

Ulcerative colitis and the colon

Ulcerative colitis is a chronic – or lifelong – inflammatory bowel disease of the large intestine, also known as the colon. It’s characterized by inflammation and tiny open sores, or ulcers, which develop on the lining of the colon.

But to truly understand ulcerative colitis, it’s important to understand the role that the colon plays in the body. As part of the lower gastrointestinal (GI) tract, the colon’s main function is to absorb water and any remaining nutrients from stool before it’s eliminated from the body. For a person with ulcerative colitis, inflammation and ulcers disrupt this important part of the digestive process.

What is ulcerative colitis?

Ulcerative colitis is an immune disorder, which triggers an abnormal immune response: the immune system mistakenly treats normal intestinal matter – like food, bacteria, etc. – as foreign or invading substances.

Because it identifies these things as “threatening”, the immune system sends white blood cells – which fight toxins and other foreign matter – into the lining of the colon. Here, the white blood cell activity causes inflammation and ulcerations, producing blood, pus and mucous.

What causes ulcerative colitis?

There is no known cause of ulcerative colitis. Researchers believe it’s a combination of nature (genetic factors) and nurture (environmental factors). Both bacterial and environmental triggers – such as diet, antibiotic use and lifestyle – are points of interest for further study.

Who is affected by ulcerative colitis?

Ulcerative colitis doesn’t discriminate. This means both men and women – of any age – can develop the disease, but most people are diagnosed in early adulthood. The disease tends to run in families, although no clear inheritance patterns have been established, and it’s more common in Caucasians of European decent—particularly among people of Jewish heritage.

How is ulcerative colitis different from Crohn’s?

If you’re interested in (or affected by) ulcerative colitis, you might also be familiar with another inflammatory bowel disease called Crohn’s. Although both are immune diseases that share many of the same signs and symptoms, ulcerative colitis and Crohn’s are not the same.

While ulcerative colitis affects the inner lining of the colon, Crohn’s can affect any part of the GI tract—from mouth to anus. And unlike ulcerative colitis, the inflammation associated with Crohn’s can occur throughout the entire intestinal wall, and sometimes in patches (diseased areas alongside healthy areas).

Ulcerative colitis management

The treatment plan for ulcerative colitis depends on the severity of the disease. Once that’s been determined, a qualified healthcare practitioner will likely prescribe a combination of things, including drug therapies, dietary changes, supportive therapy, and psychotherapy. In more serious cases, surgery to remove the colon might be necessary.

Ulcerative colitis has a relapsing-remitting course; there are periods when symptoms flare up, and periods without symptoms. The goal of treatment is to increase remission time between flare-ups and to avoid surgery. The surgery is the removal of the colon. But with proper treatment and lifestyle modifications, ulcerative colitis can be managed and people living with the disease can lead normal lives.