About UC

What is IBD?
Inflammatory Bowel Disease (IBD) is a chronic inflammatory condition of the digestive tract.

Ulcerative colitis and Crohn’s disease are forms of IBD

• Ulcerative colitis involves inflammation of the inner lining of the colon and rectum
• Crohn’s disease may involve inflammation anywhere in the digestive tract, from the mouth to the rectum

NOTE: Inflammatory bowel disease (IBD) is often confused with irritable bowel syndrome (IBS) due to the similarity of their names. Although IBS may involve abdominal discomfort and altered bowel habits, it is not the same condition as ulcerative colitis and Crohn’s disease and is treated differently. Unlike IBD, there is no evidence that inflammation plays a role in causing IBS symptoms.

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What is UC?
Ulcerative colitis involves inflammation of the inner lining of the colon and rectum. Ulcerative colitis is characterized by flare-ups followed by periods of remission that can alternate throughout a lifetime.

What is a flare-up?
A flare-up is when the rectum and/or colon become inflamed. During a flare-up, people experience periods of increased symptoms of ulcerative colitis, such as bloody diarrhea, rectal bleeding, abdominal pain or cramping, and an urgent need to go to the bathroom. Flare-ups can vary in duration and intensity.

What is remission?
Remission is the time between flare-ups of ulcerative colitis when people experience few, mild, or no symptoms of ulcerative colitis. Periods of remission vary in duration, anywhere from a matter of days to a number of years.

While ulcerative colitis is a lifelong condition, flare-ups can be controlled and periods of remission maintained with the help of your doctor.

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• Rectal bleeding
• Abdominal pain/cramping
• Urgent need to go to the bathroom
• Bloody diarrhea
• Fever
• Fatigue
• Weight loss

Most symptoms can be managed with your doctor.

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Diagnosing ulcerative colitis may include the following:

• A thorough medical history and physical exam to detect signs and symptoms of ulcerative colitis (e.g., abdominal tenderness, weight loss)
• Stool test
• Blood test
• An X-ray to provide your doctor with a picture of your intestines
• An endoscopy, such as a lower endoscopy, sigmoidoscopy or colonoscopy, which is a procedure where a rectally inserted instrument is used to view the interior of the colon

It's important that your doctor performs these tests to diagnose your condition and treat your condition appropriately.

Though ulcerative colitis can be unpredictable, treatment usually can provide people with a measure of control over this tough, persistent condition.

Following your doctor's recommendations can play an important role in managing your symptoms and in extending your remission.

Monitoring ulcerative colitis
Ulcerative colitis is monitored using many of the same techniques used to diagnose ulcerative colitis, including colonoscopies and biopsies.

• Talk with your doctor about how often he or she recommends having a colonoscopy
• Having biopsies:
  • During a colonoscopy, your doctor may take a small tissue sample during an examination of the rectum and colon
  • This biopsy may be used to measure changes in your condition or to periodically check for the possibility of other conditions, such as cancer³
• Taking blood tests:
  • Blood tests are an important and necessary part of monitoring ulcerative colitis, especially since you may be taking medications

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IBD or IBS?
Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are often confused due to the similarity of their names. However, it is important to realize they are quite different conditions with different causes, although they have some symptoms in common such as abdominal discomfort and bowel irregularity.

In IBD, inflammation is the main cause of symptoms. In IBS, symptoms may be caused by the heightened stimulation of the bowel by lifestyle factors (such as stress, diet, hormones or minor irritants) and abnormalities in the rate at which the bowel moves material.

Adapted from Steinhart and The Merck Manual.⁵

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Questions for your doctor
Here's a list of some possible questions you may want to ask your doctor. Print this list and add questions of your own. You may also want to write down the answers as you discuss them with your doctor.

1. What should I do to prepare for a test/procedure?
2. Are there risks involved with this test/procedure?
3. About how long will the test/procedure take?
4. Should someone accompany me to this test/procedure?
5. Will I need to be sedated for this test/procedure?
6. Can I drive home after the test/procedure?
7. When will the results of this test be available?
8. How often will I need to repeat this test/procedure?
9. How often will I need to have a check-up?

Other questions? Print questions and add your own

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UC and Colon Cancer
Discuss with your doctor the importance of screening and surveillance for early detection of colon cancer.

Cancer occurs when the normal process of cell growth goes out of control, producing a mass of unhealthy cells. For people with ulcerative colitis, colon cancer in particular can be a concern. Many UC patients read or hear that, over time, their risk of developing colon cancer also known as colorectal cancer (CRC), is higher than that of the general population. Although more than 90% of patients with IBD never develop cancers, it's important to be aware of what can put you at an increased risk of getting CRC and what you may be able to do about it.²

Some important clarifications put things into perspective:

1. Not everyone with UC will develop colon cancer. The risk of getting colon cancer in patients who have had UC for more than 10 years increases at a rate of approximately 0.5% per year.²
2. The risk of developing colon cancer varies from person to person and depends on many factors, including the duration or length of time you've had UC. Studies show that the risk begins to rise above that of the general population after 8-10 years of having UC. Also, the amount of intestine involved (also known as the extent of the disease) is a risk factor. People whose UC affects the entire colon are at higher risk than those whose UC is limited to one section.²

General risk factors
According to the Canadian Cancer Society, there are risk factors for colorectal cancer that affect the general population, but their relationship to UC is not well established. It is important to discuss UC-related CRC risk factors with your doctor. The following are risk factors for CRC:

• Aging
• Personal history of CRC
• Family history of CRC
• Diet
• Obesity
• Lack of exercise
• Polyps — small growths on the inner wall of the colon and rectum

Early detection is critical
While not every person with UC will develop colon cancer, you should discuss with your doctor the importance of monitoring ulcerative colitis and screening for early detection of colon cancer.

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