First diagnosed with ulcerative colitis seven years ago, Jay is able to follow a normal schedule for a 30-something male. He needs numerous large pills every day to manage the symptoms that used to plague him, and he has a colonoscopy once a year. Other than that he has few restrictions on his active lifestyle.

Ulcerative colitis is characterized by inflammation and open sores known as ulcers in the lining of the large intestine. Symptoms can range from mild to severe and may include fever, anemia, loss of appetite, aching joints, liver disease and skin lesions.

The disease usually is fairly easy to diagnose with a physical examination, stool sample, blood tests and a colonoscopy.

The inflammation of ulcerative colitis usually affects only the rectum and lower portion of the large intestine, but occasionally the entire colon becomes inflamed.

About five percent of patients with ulcerative colitis eventually develop colon cancer, and the risk increases in relation to the amount of intestine that is affected. When only a small portion of the colon is involved, the risk of cancer is minimal to low; when the entire large intestine is affected, the risk is 32 times greater than normal.

Doctors usually recommend yearly colonoscopies to monitor the extent of the ulcerative colitis and to check for signs of cancer.

For more severe cases, corticosteroids are needed to control inflammation. There are times when symptoms seem to go away for several months at a time. There are other occasions when additional medications are needed to deal with symptoms.

Infliximab is a biologic therapy approved for the treatment of moderate to severe ulcerative colitis in patients who have not responded to other treatment. Administered intravenously, it works by interfering with body’s inflammatory response.

When medications don’t work or cease to become effective, surgery is the only curative option. This involves removing the colon and the lining of the rectum, eliminating not only the source of inflammation but the risk of colon cancer.

All surgical options have risks and possible complications. For a young patient, an ostomy bag may be inconvenient and embarrassing; pouches, on the other hand, can become infected or inflamed. The preferred method depends on the patient’s needs, expectations and lifestyle.

Striking as it usually does in the prime years of life, ulcerative colitis can be frustrating to deal with. A daily regimen of pills is a minimal inconvenience compared to the abdominal pain and diarrhea that can cramp a person’s lifestyle and ability to carry out a job.

For most Americans, one colonoscopy every 10 years is reason for anxiety. Jay smiled when he heard them complain; he had no problem with a yearly colonoscopy because it gave him peace of mind and his doctor an insight into the best methods of treatment.



Rupp is information and assistance case manager with the Northern Oklahoma Development Authority Area Agency on Aging.