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WHAT IS ULCERATIVE COLITIS?

 

Ulcerative colitis (UC) is a chronic, autoimmune disease that causes great inflammation of the colon, or large intestine. Ulcerative colitis is a form of Inflammatory Bowel Disease (IBD), with the other form being Crohn’s Disease. The primary difference between ulcerative colitis and Crohn’s disease is that the inflammation caused by ulcerative colitis specifically targets the colon, whereas the Crohn’s disease can cause inflammation in both the large and small intestine (entire gastrointestinal tract). Another fundamental difference between the two forms of IBD is that ulcerative colitis presents continuous inflammation, whereas with Crohn’s disease, it is more common to see healthy and inflamed tissue adjacent to each other (Kobayashi, T. et al). There are many possible culprits for the origination of ulcerative colitis. According to the Crohn’s and Colitis Foundation, some of these potential causes include abnormal immune responses to a virus or bacterial infection, environmental factors, or even genetics. 

Diagram of Digestive/Gastrointestinal Tract

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Common Symptoms 

Common 

Symptoms

Those with ulcerative colitis experience both periods of flares (where symptoms are present) and remission (where symptoms subside). Each patient’s symptoms and pain tolerance are unique. Unfortunately, there is no cure for ulcerative colitis at this time. While the symptoms and indicators of ulcerative colitis are crucial to recognize, there are other, more invisible symptoms that UC presents inhibiting daily activities and impacting quality of life. These kinds of symptoms have a widespread impact, affecting the “…psychological, familial, social, and professional dimensions of a patient’s life” (Kobayashi, T. et al).  
 
Intestinal Symptoms
Urgent or painful bowel movements
Blood in stool
Abdominal cramps and pain
 
Other Symptoms
Lack of appetite
Rapid weight loss
Fever
Low energy and fatigue
Nausea
Lack of iron   
 
Although symptoms vary in different patients, “…about half of all ulcerative colitis patients experience mild symptoms.” Typically, periods of remission last longer than flares, spanning many months or potentially years (Crohn’s and Colitis Foundation). The unpredictable nature of ulcerative colitis can increase the difficulty of treatment, as each patient may have a different degree of symptoms and flare-up patterns. Additionally, the limitations of these symptoms varies, however, both ulcerative colitis and Crohn’s disease commonly reduce functionality of patients (Kobayashi, T. et al).    

Adolescent vs Adult Diagnoses 

 

Adolescent Diagnosis
Typically, most patients in the adolescent age range are diagnosed with ulcerative colitis between the ages of 15 to 20 (Kahn). Additionally, an adolescent diagnosis of ulcerative colitis can prove extremely challenging due to the fact that “children and adolescents with IBD have a diminished health-related quality of life (HRQOL), and adolescents are particularly susceptible to psychological stress” (Kahn). A key distinction between adolescent and adult ulcerative colitis diagnoses is that adults more commonly experience left-sided ulcerative colitis, whereas younger patients more commonly experience pancolitis, or inflammation of the entire colon. Furthermore, adolescent ulcerative colitis has been proven to be more aggressive than that of an adult, proven by the fact that adolescents require more biologic medications and hospitalization (Kahn). Receiving the diagnosis of ulcerative colitis is overwhelming; patients are expected to understand their disability, medications, and side effects, which can be daunting for children and adolescents. Thankfully, though, there is typically more support for younger patients navigating this new journey.
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Adult Diagnosis
Although ulcerative colitis can present itself in patients of all ages, “it is most commonly diagnosed in the second and third decades of life” (Gros). In fact, while most ulcerative colitis patients receive a diagnosis before they are 30, some patients may not receive a diagnosis until after they are 60 years old (Mayo Clinic). Typically, adults and older patients experience left-sided ulcerative colitis, which, as the name indicates, produces higher levels of inflammation on the left side of the colon (Kahn). When it comes to ulcerative colitis in adults, there are more long-term risks. Some of these risk include undergoing a colectomy (surgical removal of the entire colon), experiencing colorectal cancer after about 20 years of living with the disease, and a slightly lower life expectancy (about 5 years shorter) (Gros). When treatments for older patients (age 65+) for ulcerative colitis such as steroids or azathioprine are used, there is an increased risk of infection and malignancy; this could be do to aging factors such as physiological changes or slower metabolism (Gros).  
Understanding Ulcerative Colitis

Copyright 2025 Allyson Bartels Thesis

Understanding Ulcerative Colitis

Copyright 2025 Allyson Bartels Thesis

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