This disease typically begins in the sigmoid colon and/or rectum, and then usually progresses until the entire colon is affected. Ulcerative colitis involves only the colonic mucosa, and the lesions are uniform and continuous with no areas of normal tissue interspersed between the diseased mucosa.
It is seen in both sexes equally, although white and Jewish people are more often affected. A person is five times more likely to get it if one parent has the condition. Peak occurrence is from 15-35 years of age, although any age is susceptible.
About half of patients with ulcerative colitis have mild symptoms. Ulcerative colitis may also cause problems such as arthritis, inflammation of the eye, liver disease (fatty liver, hepatitis, cirrhosis, and primary sclerosing cholangitis), osteoporosis, skin rashes, anemia, and kidney stones. No one knows for sure why problems occur outside the colon. Scientists think these complications may occur when the immune system triggers inflammation in other parts of the body. These problems are usually mild and go away when the colitis is treated.
A common subcategory of ulcerative colitis is ulcerative proctitis. For approximately 30% of all patients with ulcerative colitis, the illness begins as ulcerative proctitis. In this form of the disease, bowel inflammation is limited to the rectum. Because of its limited extent (usually less than the six inches of the rectum), ulcerative proctitis tends to be a milder form of ulcerative colitis. It is associated with fewer complications and offers a better outlook than more widespread disease.
If candida or a bacterial overgrowth is present, further recovery in ulcerative colitis can be achieved by correcting the imbalance through antimicrobial or antifungal agents.
In order to confirm the diagnosis, testing may include barium x-rays of the upper and lower GI tract, flexible sigmoidoscopy, and sometimes colonoscopy. During these tests, biopsies may be obtained.