Tags: IBD
Ulcerative colitis is a chronic disorder affecting the large intestine (colon). The digestive system (including the stomach, small and large intestines) converts food into nutrients and absorbs them into the bloodstream to fuel our bodies. The colon’s main role is to absorb water and salts from undigested food waste. This action helps to thicken and solidify the stool, which is then expelled from the body through the anus.
Ulcerative colitis causes inflammation (redness and swelling) and ulceration (sores) along the lining of the colon which can lead to abdominal pain, cramps, bleeding and diarrhea. The disease usually begins in the rectal area, which holds stool until you go to the bathroom, and may involve the entire colon over time. Ulcerative colitis is classified as an inflammatory bowel disease (IBD), due to the inflammation that occurs in the intestines. Another common form of IBD is called Crohn’s disease. Although the symptoms of ulcerative colitis are similar to Crohn’s disease, the conditions are different in several ways.
While both ulcerative colitis and Crohn’s disease are types of IBD, they should not be confused with Irritable Bowel Syndrome (IBS), a disorder that affects the muscle contractions and the sensitivity of the colon. Unlike ulcerative colitis and Crohn’s disease, IBS does not cause intestinal inflammation nor damage the bowel.
There is currently no known way to prevent or cure for ulcerative colitis (IBD) but the proper strategy for managing your disease can help you lead a happier, healthier, fulfilling life.
The exact cause of ulcerative colitis is unknown. However, it is believed to be due to a combination of factors, including a person’s genes (inherited traits) and triggers in the environment. This interaction of genetic and environmental factors activates an abnormal response of the body’s immune system.
Normally, the immune system protects the body from infection. In people with ulcerative colitis, however, the immune system can mistake microbes (such as bacteria that are normally found in the intestines), food, and other material in the intestines, as invading substances.
When this happens, the body launches an attack, sending white blood cells into the lining of the intestines where they cause inflammation and ulcerations.
Ulcerative colitis is a chronic (long-term) condition with symptoms that can disappear and then flare up again throughout your life. Living with the unpredictable nature of ulcerative colitis can pose physical and emotional challenges that may seem overwhelming at times. However, there are several things that you can do to contribute to your health and well-being.
Be informed, proactive, and involved in your care. By establishing a solid partnership with your health care team, developing coping skills, and maintaining a positive outlook, it is possible to stay healthy and happy, despite living with ulcerative colitis.
Although diet and stress do not cause ulcerative colitis, there may be times when changes in your lifestyle may help control your symptoms and lengthen the time between flare-ups. The following changes may help to ease your symptoms:
Ask your doctor or pharmacist if one of these formulations may be right for you. It is important to take the probiotic in the dose and duration recommended by the manufacturer to achieve the best results.
Citations:
Canadian Digestive Health Foundation. 2009. Establishing digestive health as a priority for Canadians. The Canadian Digestive Health Foundation – National Digestive Disorders Prevalence & Impact Study Report.
Crohn’s and Colitis Foundation of Canada. 2012. The impact of inflammatory bowel disease in Canada - 2012 Final report and recommendations.http://crohnsandcolitis.ca/Crohns_and_Colitis/documents/reports/ccfc-ibd-impact-report-2012.pdf?ext=.pdf [accessed 3 September 2018] [accessed 3 September 2018]
Fedorak RN et al. Canadian Digestive Health Foundation Public Impact Series 4: Inflammatory bowel disease in Canada. Incidence, prevalence, and direct and indirect economic impact. Can J Gastroenterol. 2010 Nov;24(11):651-5.
The most common symptoms of ulcerative colitis are abdominal pain, diarrhea, blood in the stool and false urges to have a bowel movement.
If you are already diagnosed with ulcerative colitis, there are several alarm symptoms to look out for. A change in your ulcerative colitis symptoms may mean that additional treatment is needed. Talk to your doctor immediately if you experience a new symptom, a change in your current symptoms or any of the following:
Yes. There are some complications related to ulcerative colitis. Possible complications include:
People with ulcerative colitis are also at increased risk of developing colon cancer. The risk of colon cancer is related to the length of time since you were diagnosed and how much of your colon is affected by inflammation. However, a regular examination by your doctor and colorectal cancer screening tests can help to reduce the risk of cancer and detect problems early.
Not showing symptoms for COVID-19? You should still be taking care to practice social distancing!
The fact of the matter is, even if you’re not showing any symptoms, you can pass this virus on to people who ARE at risk. This not only means the elderly in our community, but people who are have compromised immune systems. Many IBD patients, for example, are on medications that suppress the immune system, and it’s times like these that we need to band together and think of our neighbours. People who suffer from a chronic underlying conditions chronic respiratory illnesses, diabetes, cancer, etc are also at risk. We must be proactive now and get in front of this pandemic.
Practicing social distancing is the best way possible to keep this virus from spreading and potentially harming more people in our community. If you are not taking immunosuppressive medications and your condition is currently in remission, you are at the same level of risk as the general public, according to Crohn’s and Colitis Canada. However, if you are taking an immunosuppressive medication, make sure to continue taking your medications and prioritize social distancing as soon as you can.
If you are not showing any symptoms, please refrain from any in person visits with a doctor. Healthcare professionals will be working day and night to help the infected, and they must prioritize at risk patients. If we all take care and do our best to protect one another by following the advice of the Public Health Agency of Canada, we have to potential to save countless lives while we wait for a viable vaccine.
We know there’s a lot of information being shared online, so we have decided to make a list of relevant links to help you easily find the best resources for you:
You can learn more about health and safety recommendations for patients by going to the Crohn’s and Colitis web page here: https://crohnsandcolitis.ca/Living-with-Crohn-s-Colitis/COVID-19-and-IBD
Health Canada also has information and recommendations for the general public on how to safely navigate this pandemic.https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html
For additional information about COVID-19 in your area, please visit the links below:
Federal COVID-19 information
Travel Advice and Advisories
Ontario COVID-19 information
British Columbia COVID-19 information
Quebec COVID-19 information
Alberta COVID-19 information
New Brunswick COVID-19 information
Newfoundland and Labrador COVID-19 information
Nova Scotia COVID-19 information
Prince Edward Island COVID-19 information
Manitoba COVID-19 information
Saskatchewan COVID-19 information
Yukon COVID-19 information
Northwest Territories COVID-19 information
Nunavut COVID-19 information
Often, symptoms alone can provide doctors with the information they need to diagnose ulcerative colitis. Your doctor will perform a physical examination and take a complete medical history that includes a careful review of your symptoms. For this reason, it is important to be candid and specific with your doctor about the problems you are having.
There is no one specific laboratory test, X-ray or scope to diagnose ulcerative colitis, however, to help confirm the condition and rule out other problems, your doctor may send you to have one or more of the following tests:
There is no cure for ulcerative colitis at the present time, however, there are effective treatments available that may control your disease and even place it into remission. Remission means that your symptoms disappear completely. Your treatment plan will depend upon the types of symptoms you have, their severity and how they affect your daily life.
Medications may be needed to control the inflammation in your colon and/or to reduce your body’s immune response. The goals of treatment are to manage your symptoms and prevent them from coming back so that you can live life to its fullest. You and your physician should discuss and carefully consider the risks and benefits associated with any available treatment options. Often, medications are prescribed in a ‘stepped’ approach, beginning with relatively safe medications with few risks or side effects, and progressing to more powerful medications with additional risks and side effects, if your symptoms do not respond. The following list outlines the most common medications used to treat ulcerative colitis.
About 10 to 15% of people with ulcerative colitis may eventually need surgery to treat their condition, if medical therapy is not successful or complications arise. Ulcerative colitis surgery usually involves removing the entire colon and rectum (proctocolectomy).
When the colon is completely removed, a small opening (stoma) is created in the lower abdomen and feces (digestive waste) are collected into a small bag worn on the outside of the body. For some people, a second operation (called a pouch procedure) can be performed. This operation creates a new rectum, which allows feces to collect inside the body and be expelled by normal passage through the anus. People with pouches often still pass 4-6 stools per day, but without blood or pain.
The symptoms of ulcerative colitis can be disruptive, debilitating and embarrassing. In addition to medication to control inflammation, your doctor may recommend additional products to help relieve your symptoms, including antibiotics (for fever), pain relievers (for abdominal pain), antidiarrheals (to control diarrhea) and iron supplements (for anemia). Talk to your doctor about which medications are safe for you to take.
Click here for more information on diet and lifestyle for IBD.
Studies have found that, in some cases, probiotics may help to improve symptoms of ulcerative colitis. Probiotics are live microorganisms that, when taken in adequate amounts over sufficient time, may provide a health benefit. They are natural, ‘healthy’ bacteria that may help with digestion and offer protection from harmful bacteria in the intestines.
Probiotics are not medicine. They are available to purchase as capsules, tablets or powders, and can also be found in some fortified yogurts and fermented milk products. However, not all probiotics are the same. Although many products claim to have benefits, only two probiotics formulations – E. coli Nissle and VSL#3 – have been shown to be effective in ulcerative colitis.
Ask your doctor or pharmacist if one of these formulations may be right for you. It is important to take the probiotic in the dose and duration recommended by the manufacturer to achieve the best results.
Am I going to get cancer because I have (Ulcerative Colitis) IBD?
People with IBD are at an increased risk of developing colon cancer. Having regular endoscopies will help identify polyps that could potentially develop into cancer.
Does diet affect Ulcerative Colitis (IBD)?
Diet alone is not effective in treating Crohn's disease or ulcerative colitis. However, it is important that patients with IBD have a well-balanced diet. Calcium is important to protect bones. Fibre may not be tolerated during flare ups. Certain vitamins (for example, B12) may be required. Selected patients may sometimes be helped by a registered dietician.
How is Ulcerative Colitis (IBD)different than IBS?
Although both illnesses can be seriously debilitating, there are several primary differences between Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS). IBD is an autoimmune disorder that causes swelling and ulcerations (sores) in the bowel. IBS involves problems with motility (how the bowel moves contents through our intestines) and sensitivity (how the brain interprets sensations in the bowel). Symptoms of IBS may wax and wane and possibly disappear altogether whereas IBD is a chronic condition.
How can I tell if my treatment is working?
For some people, ulcerative colitis symptoms will significantly improve within a short time after starting medication or making lifestyle and dietary changes. For others, finding relief from symptoms is a slow process and it may take longer for a definite improvement to be noticed. It is important for you and your doctor to work together to determine what triggers your symptoms and to find the right treatment to manage your symptoms effectively.
How can I prepare for an appointment with my GI to discuss my ulcerative colitis?
Good communication with your doctor is an important part of effective management of a gastrointestinal disorder like ulcerative colitis. Before your appointment, take the time to keep a symptom journal that can help you and your doctor see patterns in your activities and identify specific triggers for your symptoms.Include the following information in your journal:
Also, create a list of questions to ask your doctor during your appointment. Specifically, you may want to ask your doctor questions such as:
It’s #IBDAwarenessMonth, and to mark the occasion, Effie, Katie and Emma are sharing their advice for Canadians living with #ulcerativecolitis. Here’s how you can live your best life with #UC.
At the start of 2020 the government announced that coverage was changing for people who take Remicade® (infliximab) for the treatment of Crohn’s disease or ulcerative colitis. This meant that patients receiving the biologic drug infliximab, marketed as Remicade®, would see this coverage discontinue with new coverage for the biosimilar version: Inflectra and Renflexis.
Ulcerative colitis advocate Effie was one of those people. In this self-produced video, Effie talks all about her experiences with switching to a biosimilar, takes us through her first Inflectra infusion, and answers some of the same questions you may be asking yourself if you will be going through the same process:
For more information on biosimilars, click here.
Have you already been switched/transitioned to a biosimilar version of Remicade® (infliximab)? Take our Patient Survey
Helping inflammatory bowel disease (IBD) patients best understand transitioning/switching from a reference biologic to a biosimilar.
[flipbook pdf="https://cdhf.ca/wp-content/uploads/2021/04/CDHF-EnglishBiosimilarTransitionPathwayBrochure.pdf"]
Updated March 20201
Having to change any kind of medication can be very stressful. While CDHF believes in patient-physician choice, we acknowledge political policy decisions and our organization is committed to providing clear and unbiased information and resources for patients. Both biologics and biosimilars have gone through rigorous standards for authorization by Health Canada, to which both have been found safe and effective for use in Inflammatory Bowel Disease (IBD). Watch this video to learn more about switching from a biologic to a biosimilar.
Making informed decisions is imperative to your good health but understanding the benefits and risks associated with Ulcerative Colitis (UC) treatment options can be challenging. CDHF developed the IBD BRAT - a tool to help you learn more about common risks as well as important benefits around the therapy options. Check out our detailed online version by clicking here, or download the coles notes version below!