Ulcerative colitis is an inflammatory bowel disease (IBD) that affects the large intestine.   Learn more about the disease and measures you can take to manage the symptoms.


A new diagnosis of ulcerative colitis can be a totally unfamiliar and sometimes downright scary situation. The main reason being that it could be a totally unknown disease to you. 

This article aims to ease your potentially troubled mind by providing you with the facts regarding what to expect when you receive a diagnosis of ulcerative colitis such that you can be prepared for what is to come. 

Several potential treatment paths will also be looked at such that you can be prepared for the different eventualities. 

The right expectations will assist you in preparing for the associated symptoms and related lifestyle changes that may be necessary to get a proper grip in dealing with the new diagnosis.



What Ulcerative Colitis is Not

With the above introduction, you may be tempted to feel a sense of trepidation at the onset of a deadly disease. 

Well, that’s where we should nip that fear right in the bud. You see, ulcerative colitis is not a life-threatening disease in the slightest. 

Ulcerative colitis is one of several inflammatory bowel diseases, or IBD’s. 

What this means is that it involves digestive tract disorders generally as a result of chronic inflammation due to an overactive immune system response. This may bring a term to mind – “Crohn’s Disease”. 

Ulcerative colitis is not Crohn’s disease although the two are commonly confused. 

Ulcerative colitis is more localized in its effects with the large intestine being the only part of the digestive tract being affected. 

This is in contrast to Crohn’s disease which can affect any part of the gastrointestinal tract although it is most commonly found in the small intestine and colon. 

There are also differences in disease appearance. 

Ulcerative colitis presents as a continuous area of inflammation that is not broken up by healthy tissue as is the case with Crohn’s disease. It may also present as visible sores on the lining of the colon whereas this is absent in Crohn’s disease. 

The distinction between the two forms of IBD is not always crystal clear.

When a doctor is unable to determine whether a patient has ulcerative colitis or Crohn’s disease, they will classify the patient’s condition as “indeterminate colitis” implying that there are cases where it’s not always clear one way or the other. 



Symptoms to Expect and How to Manage Them


Ulcerative colitis symptoms may vary due to the location of the disease in the colon as well as the severity of the inflammation.

That said, most people only experience mild to moderate symptoms interlaced with periods of remission.

Initially, patients will experience some bowel-related symptoms such as diarrhoea, abdominal cramping, and nausea.

Other common symptoms that patients may notice early one is general fatigue (tiredness), anaemia (due to a reduction in red blood cells), blood in bowel movements, fever and weight loss. 

These are seen as mild to moderate symptoms. 

Though less common, patients may exhibit some or all of the followings signs as well:

  • Eye irritation (resulting in red eyes)
  • Joint pain
  • Rashes

Again, these are less common and do not directly indicate the presence of ulcerative colitis, especially without the presence of the previously mentioned more common bowel-related symptoms. 

Managing the symptoms of ulcerative colitis has lots to do with understanding one’s diet and changing habits where necessary 

In general, some food choices make ulcerative colitis symptoms worse.

These include carbonated drinks, popcorn, vegetable skins, nuts, and high-fibre foods (when symptoms are present). Again, this will vary between patients but is a good place to start. 

When starting a dietary change in response to ulcerative colitis, one’s doctor may recommend that one drinks more water, eats smaller but more frequent meals, and, importantly, keeps a food diary to track particular foods that may be causing symptoms. 

Apart from the longer-term symptom management related to changes in the diet, medication prescribed by one’s doctor is the most effective way to ensure a minimization in flare-up risk. 

Combined with a healthier, more personally balanced diet, prescribed medication serves as the best route to achieving and maintaining remission. 

Even during a period of remission, occasional symptoms may still flare up especially early on in one’s diagnosis. In these instances, one’s doctor or pharmacist should be able to direct one to some over-the-counter options that will assist with decreasing the severity of these symptoms.



Potential Treatment Paths for Ulcerative Colitis

Ulcerative colitis treatment typically involves either drug therapy or surgery. Surgery is only necessary when the case is severe, and no other treatment can work.

Depending on the severity of your condition, there are several categories of drugs that may be effective in treating ulcerative colitis.

The condition does affect individuals differently due to the complexity of each person’s immune system and the way it interacts with the colon.

Therefore, it is essential for one to consult with one’s doctor personally to find the potential solution for one’s specific situation.


That said, here are several methods of treatment being used today:

Anti-inflammatory drugs: These are often the first step in the treatment of ulcerative colitis and are appropriate for the majority of people with this condition. These drugs include 5-aminosalicylates and corticosteroids 

Immune system suppressors: These drugs also work to reduce inflammation, but they do so by suppressing the immune system response that starts the process of inflammation. In some instances, one’s doctor may prescribe a combination of these drugs rather than one single medication. 

Biologics: These therapies selectively interact with processes in one’s body to treat a number of diseases and their symptoms. Medications such as Infliximab are currently registered in South Africa for the treatment of Ulcerative Colitis. 

Other medications: In addition to controlling inflammation, some medications may help relieve symptoms. Always talk with one’s doctor before using over-the-counter medications, but they will be able to guide one to the correct symptom relief medications such as anti-diarrheals, pain relievers, antispasmodics, or iron supplements. 

Surgery: If medications do not effectively control one’s symptoms and achieve remission, one’s Gastroenterologist may recommend surgery. This can eliminate ulcerative colitis and involves removing one’s entire colon and rectum (proctocolectomy). 

Even with treatment and reaching remission, one can experience flare-ups of inflammation again at any stage. 

This would indicate that a new medication or an adjustment to dosage should be considered. 

One needs medical care for as long as the gastroenterologist deems necessary and, for this reason, regular visits to monitor one’s condition is recommended.



 Can Ulcerative Colitis Clinical Trials be Beneficial?

While a clinical trial is certainly not a necessity for every ulcerative colitis patient, it does provide some beneficial points that should be considered. 


1. Treatment that may be free or low cost.

Some clinical trials may pay for part or all of one’s treatment, other medical care, travel, and other expenses during the study. But not all clinical trials do this.


2. More personal care.

The research team that conducts clinical trials usually includes not just the main researcher but a whole team of scientists and doctors focused on this particular trial process. 

They work as a team to monitor the effects of the treatment.

Because of this close monitoring, any side effects one might have are noticed and dealt with immediately. 

In general, researchers may provide one with medical care and more frequent health check-ups as part of one’s treatment than one’s regular doctor.


3. Access to new treatment.

The trial will test a treatment, or part of a treatment, on oneself.

There is the chance that it will be more effective than the treatment one is currently using.

What’s also likely is that this new treatment will contain fewer side effects which will make one’s life significantly more comfortable if one is currently suffering from side effects as a result of one’s current treatment.


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Don’t let a new diagnosis scare you – Ulcerative colitis is a chronic condition that is not uncommon in the world. 

It can cause quite a hindrance to daily life and may even result in some patients having to make drastic life changes to cope with the sometimes severe symptoms but there are well-known methods to improve quality of life. 

By understanding the various symptoms, they can cause and available treatments, you can be rationally prepared for what is to come and thus give yourself a great chance at making the best of the situation. 

For medical advice, remember to consult with your doctor. If you’d like to learn more about inflammatory bowel diseases and our medical trials process, visit Spoke Research.

Medical surveys

Future treatments are now one step closer. 

Contact us

Spoke Research Inc
Mediclinic Milnerton,
Suite 109
Racecourse Rd, Milnerton
Cape Town


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