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Ulcerative Colitis
















What is Ulcerative Colitis?

Ulcerative Colitis - bowel anatomy


Ulcerative Colitis is an inflammatory condition affecting only the rectum and colon (large bowel). The cause is unknown. The symptoms of ulcerative colitis can sometimes be confused with Crohn's disease.




What symptoms can Ulcerative Colitis cause?

Symptoms vary between people, but will tend to have periods of exacerbations followed by 'quiet' periods. Generally, ulcerative colitis symptoms may include:

  • Diarrhoea, which can be up to 15 times per day. Blood and mucus may be in the motions.

  • Abdominal pain and tenderness

  • Fever

  • Loss of energy

  • Weight loss


The inflammation can lead to strictures and narrowing of the bowel wall, which may eventually cause complete obstruction of the bowel. Fistulas and bowel perforations can occur, as can painful fissures of the anus. The risk of developing bowel cancer increases with how long ulcerative colitis continues, and can be up to 20% in those that have had UC for 20 years or more. Other problems associated with ulcerative colitis include eye, joint and skin problems.


What tests can be done for suspected ulcerative colitis?

Your doctor may arrange a number of tests, including blood tests, special x-rays, scans and telescope tests such as colonoscopy.


What treatment options are there for ulcerative colitis?

Malnourishment can be helped with a specially planned diet and vitamins. Steroids can be used during 'flare-ups', and some control may be achieved with medication or special enemas to help prevent recurrences. Regular check-ups will be performed to monitor your condition, and colonoscopies used to check for any signs of cancer.

Ulcerative colitis can cause tummy painSometimes medication does not help, and surgery may be a suitable option. Surgery may also be suitable for those that get ulcerative colitis at an early age, due to the increased risks of cancer. The operation will often involve removing the colon and rectum, thereby removing all the bowel that can be affected by ulcerative colitis; a portion of small bowel is used to replace the removed section. A temporary stoma may be needed, whereby a bag is worn on the front of the tummy to collect bowel contents and allow the surgery area to heal. The stoma is removed after a few months and the bowel reattached in the abdomen.

Occasionally ulcerative colitis can cause problems such as bowel perforation, which can make you very sick. This may well need emergency surgery to remove the affected portion of bowel.


What are the risks of surgery for Ulcerative Colitis?

  • Hernia - if the deep tummy muscles do not heal well after the surgery, the underlying bowel could push through the muscle, being seen or felt as a lump. Hernias may need an operation to treat them.

  • Infection - this may require antibiotics, or rarely further surgery.

  • Injury to other structures - injury to bowel, nerves or blood vessels is rare during ulcerative colitis surgery but can occur, which may need further surgery.

  • Bowel leakage - after the bowel ends are joined together there is a small risk that a leak may occur, allowing bowel contents to escape into the abdomen. This often needs further surgery.

  • Adhesions - surgery in the abdomen will lead to scar tissue forming. This can stick to nearby bowel, which may cause problems such as obstruction. This can require further surgery.

  • Difficulty passing urine - if this happens you may need a tube (catheter) for a day or two to help you pass water.

  • Blood clots in the legs - clots in the calf (deep vein thrombosis / DVT) can usually be treated with medication, but a DVT can (rarely) move to the lungs. This can cause breathing difficulty, or even be life threatening.



Other SurgeryWise articles

You may also be interested to read our articles on Bowel Cancer, Diverticulitis or Crohn's disease


Any procedure involving skin incision can also result in unfavourable scarring, wound infection, or bleeding. This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.

The information provided is as a guide only and you should discuss matters fully with your specialist before deciding if this is the right procedure for you. Please also read our disclaimer






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