Ulcerative colitis

Ulcerative colitis is a chronic inflammatory bowel disease affecting the lining of the colon.

Overview

Ulcerative colitis is a chronic inflammatory bowel disease affecting the lining of the colon. The cause is unknown. The disease is intermittent in nature, with alternative phases of relative well-being and episodes of cramp-like abdominal pain and slimy and bloody diarrhoea. There are no known diets or other measures to prevent this disease.

Symptoms

  • Course
    • First episode begins gradually or becomes acute within a few days, and continues for four to eight weeks
    • This is followed by several months or even several years of remission
    • Sometimes the disease is chronic from the outset
    • In 50% of cases, the inflammation is confined to the lower part of the colon
    • Other cases: the inflammation moves higher up the colon, until approx. 20% of the colon is affected
  • Main symptom: bloody and slimy diarrhoea
    • Up to 20 bowel evacuations per day
  • Cramp-like pain in the lower abdomen and rectal area
    • Continues during bowel evacuations
    • Painful urge to empty the bowels (tenesmus)
    • Pain is usually worst on the left side
  • Nausea, bloating and loss of appetite
    • Weight loss
  • Fatigue, drop in performance
  • Malnutrition
  • Less often: fever, racing heart (tachycardia)
Other risks and long-term consequences
  • Concomitant disorders of other organs in 10 to 20% of cases (less often than with Crohn’s disease)
  • Arthritis and osteoporosis
  • More rarely, inflammation of the skin, the lining of the mouth, the eyes or the liver
  • Also inflammation of the biliary tract, gallstones, kidney stones
  • Bowel cancer
    • Risk of disease increases over time as the episodes get worse
    • Risk is noticeably higher if the entire colon is affected

Causes and treatment

Causes

  • The causes are currently unknown
  • Genetic factors are suspected
    • Family history: most important independent risk factor
  • The following are also being considered: environmental factors, smoking, diet, food intolerances, psychological stress

Further treatment by your doctor / in hospital

Possible tests
  • Key examination: endoscopic examination of bowel (colonoscopy) with removal of tissue samples
  • Ultrasound (sonography)
  • Blood test
  • MRI (magnetic resonance imaging)
  • CT scan (computed tomography)
Possible therapies
  • Acute attack: very important to follow the diet recommended by a nutrition specialist
  • Infusions: fluid replacement for heavy and severely dehydrating diarrhoea
  • Medication
    • Suppression and modulation of the immune system (e.g. with cortisone, azathioprine, tacrolimus and TNF inhibitors)
    • Antibiotics in very rare cases
    • Period of remission: prevent renewed flare-ups of the disease with medication-based maintenance therapy
  • Reasons to have an operation:
    • No improvement or excessively severe side-effects of medication
    • Bowel perforation (rupture), peritonitis or uncontrollable bleeding

What can I do myself?

  • Diet
    • There are no known diets or other measures to prevent this disease
    • Periods of remission: healthy bowel diets are controversial (judged to be either essential or useless)
    • Patients are advised to identify the diet that suits them best with the help of a nutritional expert
  • For severe illness: look for psychotherapeutic support (recommendation)
  • Patients should carefully observe the progression of the disease
  • Attend a self-help group: tips and support (see “Further information” below)

Get a personal Preventive Care Recommendation now.

When to see a doctor?

  • Recurrent abdominal pain and diarrhoea without any discernible cause
  • Slimy diarrhoea with some blood in the stool
  • Unexplained weight loss
  • If diagnosis has been confirmed:
    • Go to the doctor as soon as the first signs of an attack appear (makes consistent treatment possible)
    • Constant medical supervision and long-term therapy are required
    • Monitor and regularly adjust the therapy
    • This is the only way to identify complications at an early stage
  • Pregnancy and ulcerative colitis
    • Disease does not present a hurdle
    • Attacks or relapses are typical, in particular in the first trimester
    • Constant monitoring by the gynaecologist and gastroenterologist is essential

Further information

Selbsthilfe Schweiz (Self-Help Support Switzerland)
www.selbsthilfeschweiz.ch 

Schweizerische Morbus Crohn/Colitis ulcerosa-Vereinigung (SMCCV) (Swiss Crohn’s & Colitis Association)
www.smccv.ch

Synonyms

ulcerative colitis

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