According to Medscape, ulcerative colitis (UC) creates ulcers in the large intestine. The Crohn's & Colitis Foundation says UC is caused by your immune system fighting an old infection. White blood cells assault your colon without bacteria or viruses to combat, producing pus-filled ulcers. Mucus release induces inflammation, which increases bowel movements.
3 Types Of Ulcerative Colitis
The Crohn's & Colitis Foundation lists three UC types. Ulcerative proctitis affects a portion of the rectum. Left-sided colitis affects your rectum and associated colon. Finally, severe colitis affects the whole colon. UC risk factors include: Anyone may be diagnosed at any age; however, most are 15 to 30. According to Cleveland Clinic, if a close family member has the condition, particularly if you're Jewish, your risks rise by about 20%. High-fat diets and NSAIDs increase the risk of UC.
Doctors Who Treat Ulcerative Colitis
Cleveland Clinic recommends beginning UC treatment with your usual doctor. If more testing is needed, they'll refer you to a gastroenterologist (GI) or colorectal surgeon for a colonoscopy. A gastroenterologist treats digestive issues. Colorectal surgeons conduct colon and rectum procedures. GIs manage UC treatment.
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Other doctors will also help. A nutritionist will ensure you eat things your body can handle and obtain enough nutrients—a dermatologist for skin disorders and a rheumatologist for joint difficulties. Living with a chronic ailment is difficult; therefore, physicians suggest visiting a psychologist for depression or anxiety. A third of UC patients require colorectal surgery.
The Crohn's & Colitis Foundation advises choosing a UC specialist carefully. Check that the doctor accepts your insurance, is nearby, and has a good bedside manner.
Common Medications Used To Treat UC
First-line UC treatment is aminosalicylates. 5-ASAs reduce colon inflammation and mend the GI tract, according to the NHS. If 5-ASAs don't help, the NHS suggests corticosteroids. These medications suppress your immune system. Long-term corticosteroid usage may limit or cease cortisol production, making it difficult to discontinue without relapsing.
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When 5-ASAs and corticosteroids fail, physicians often prescribe immunomodulators, and immunosuppressants alleviate inflammation by suppressing the immune system. Despite being beneficial, several medicines are administered off-label for UC. Relief might take months.
The Crohn's & Colitis Foundation suggests using biologics if immunomodulators don't help. Organic medicines inhibit inflammatory proteins. Janus kinase (JAK) inhibitors limit immune system inflammatory signals for quick symptom alleviation.
RELATED: How To Manage Ulcerative Colitis
12 Side Effects
While all FDA-approved pharmaceuticals must offer more benefit than harm, none are without side effects.
Headache
Most prescription drugs for UC patients include headaches as a side effect, and the disease's inflammation may induce headaches. You may need to adjust your Tylenol dose if you get frequent headaches. If the condition continues, your doctor may prescribe switching drugs.
Stomachache
According to Frontline Gastroenterology, several drugs produce stomachaches because they modify stomach contents. 5-ASAs, immunosuppressants, and biologics may have UC abdominal discomfort. Over 30% of UC patients experienced stomach discomfort when in remission, according to research. The disease's psychological effects may also cause pain. Diet, therapy, exercise, and medicine alleviate pain.
Diarrhea
Some physicians prescribe antibiotics for bacterial illnesses, according to MedicalNewsToday. The use of antibiotics may cause UC patients to have "a flare-up of symptoms," including diarrhea. Thus, patients should tell their doctor if they have UC before starting a new therapy, particularly if it contains antibiotics. To reduce diarrhea, take medicine, eat smaller meals more frequently, drink more water, and avoid high-fat and high-fiber foods.
Rash
Rashes are the most common pharmaceutical adverse effect, reports Pharmacy Times. According to the IBD Resource Center, nearly 20% of IBD patients consult a doctor regarding a rash. Some side effects are caused by the illness, while others are from treatment. See your doctor for topical or oral therapy, including steroids, to relieve the rash's pain.
Insomnia
The Brazilian Sleep Association notes corticosteroids affect the CNS and may induce insomnia. AARP says that although lowering inflammation, these drugs force your adrenal glands to work excessively, resulting in sleeplessness. Antidepressants (SSRIs) used for UC anxiety and depression may induce sleeplessness. The International Journal of Molecular Medicine reveals that melatonin decreases GI inflammation and improves sleep.
Dry Mouth
Your body generates saliva to help you eat, communicate, and protect your mouth from tooth decay, germs, and viruses. MedicalNewsToday research revealed that UC patients were three times more likely to suffer dry mouth than those without the condition. Antidepressants, antidiarrheals, and opioids used by UC patients induce dry mouth, according to the American Academy of Oral Medicine. Sugar-free gum and water can help relieve dry mouth.
RELATED: Can Ulcerative Colitis Cause Weight Gain?
Fever
UC antibiotics may induce fever. According to Annals of Pharmacotherapy, body temperature rises due to increased metabolism, immune system reaction, or hypersensitivity. Fever usually appears a week or longer after taking medicine. Drug-induced fevers normally disappear when the medicine is discontinued, return upon retaking it, and last as long as the prescription is taken. Three or four days off the medicine is recommended. Taking additional prescriptions makes you more prone to drug-induced fevers, so quit them one at a time.
Fatigue
Unlike sleeplessness, rest doesn't heal exhaustion (per Journal of Pain and Symptom Management). Antihistamines, antipsychotics, anticonvulsants, and alpha and beta blockers may produce fatigue, according to Harvard Health Publishing. Some UC treatments (antidepressants, nausea/vomiting meds, muscle relaxants, opioids) also sap energy. Advances in therapy recommend seeing your doctor if you have weariness during remission.
Weight Gain
Nearly 20% of Americans utilize prescription weight-gain medications, according to research in obesity. Six kinds of medicines, including steroids and antidepressants, may promote weight gain, according to the University of Rochester Medical Center. Drug-related weight gain arises from hunger stimulation, metabolic alterations, water retention, and weariness that hinders exercise. Some UC patients gain weight despite having digestive difficulties.
According to Nutritionists, a balanced diet includes just enough carbs, proteins, and fats to give energy, vitamins and minerals for physiologic functioning—MedicalNewsToday advocates eating smaller meals more regularly for patients with UC who avoid high-fiber foods. Walk for exercise, manage portions, and keep a food diary to track calories.
Mood Swings
Ten categories of drugs may alter your mood, including steroids, opioids, and antidepressants. Your doctor may be unable to tell whether your medication or the underlying illness causes your mood fluctuations. This is particularly true for patients with UC since there is no treatment and everyday effects are unknown. Talk to your doctor about dosage or medicines if your emotions are troubled. Stopping medications without seeing a doctor might increase UC symptoms and mood changes.
Infection
Though fungal illnesses resemble bacterial and viral diseases, they need distinct therapies. Corticosteroids and TNF inhibitors, two popular UC medications, increase your risk of a fungal infection, according to the CDC. Your risk of infection rises when your doctor ups your dose. If you take more than 25 mg daily, your risk of infection triples for almost a year following treatment. Avoid dust and bird droppings, and use gloves and protective clothes while gardening to limit fungal infection risk.
Risk Of Osteoporosis
Up to 60% of patients with UC and those using long-term corticosteroids have reduced bone density, according to the IBD Help Center. Until breakage, little symptoms develop. According to the World Journal of Gastroenterology, half of hip fracture patients die or are hospitalized within a year. The IBD Help Center suggests boosting exercise, calcium, and vitamin D consumption and switching drugs.
