Ulcerative colitis is a condition that causes inflammation in the linings of the large intestine or the rectum, or in some cases, both. About 750,000 people in the US are diagnosed with this condition every year. The number of undiagnosed cases, however, are still high. Here is everything you need to know about the condition, so that you can spot symptoms early on and get the treatment you need.

Disease overview
Ulcerative colitis (UC) is the chronic inflammation of the colon, which is the lining of your large intestine. It is that part where undigested food and waste materials are stored.

When the colon gets inflamed, it can also cause inflammation of the rectum, and the result is abdominal pain, a frequent need to pass stools, and general discomfort.

UC is a part of the larger group of conditions called Irritable Bowel Syndrome (IBS). This is a chronic condition, which means that the symptoms develop with time rather than suddenly.

It is said that people between the ages of 15 and 35 are mostly diagnosed with this condition.

Symptoms
The symptoms of UC can vary depending on the stage of the condition and the age of the person. However, here are some commonly noted symptoms to look out for.

• Abdominal pain: The inflammation in the colon can disrupt regular digestive processes, and this can result in mild to severe abdominal pain. Some people also experience abdominal cramps.
• Frequent urge to pass stools: This is probably one of the most common symptoms of UC. Even after going to the toilet, people with this condition get the feeling that they have not been able to clear their bowels effectively.
• Loose stools (diarrhea): The inflammation in your colon can be a result of the white blood cells (WBC) attacking the linings of the large intestine. This causes the colon to keep contracting often, resulting in frequent and loose stools. Many people mention that diarrhea is one of their earliest symptoms of UC.
• Rectal pain: The constant contraction of the colon and the frequent bowel movements can put pressure on the rectum and lead to rectal pain.
• Bloody stools – This is one of the advanced symptoms that needs to be immediately addressed. Chronic inflammation of the colon can lead to sores forming on the lining. These sores can become ulcers and bleed, resulting in your stools looking dark brown or red in color.

Causes
There are three broad categories of causes that can result in the condition.

• Genetics
  Genetics definitely plays a vital role in increasing your chances of developing UC. In fact, if one of your close family members has had this condition in the past, it puts you at a 30% higher risk of developing the condition. You can get your gene mapping done to know if this is a potential cause.
• Environmental factors
  When it comes to environmental factors, researchers suggest that a foreign antigen or a bacteria or a virus can stimulate the immune system into a “fighting mode.” This can cause the immune system to act against the body, attacking the colon and causing inflammation.
• Overactive immune system
  The immune system usually gets activated when there is a foreign presence in the body. This stray presence could be bacteria, a virus, or even fungi. However, for some people, their immune system is randomly triggered for no apparent reason. This abnormal activation of the immune system, or the overactive nature of the immune system, can result in continuous inflammation of the large intestine lining in patients. This overactive nature of the immune system also has chances of being inherited. Right now, it is identified that up to 30 genes can increase your risk of developing UC. Research in this area is still going on though.

Treatment options
Once you have been diagnosed with UC, the next step is planning the treatment method. Your doctor will take into account various factors, including your age, gender, physical activity levels, the presence of other diseases, and the severity of the condition, to chalk out a treatment plan.

There are three broad areas of treatment usually offered.

Medications

• 5-ASA: Also called as 5-AminoSalicylic Acid, this is one of the first treatment options for UC. Doctors usually start with this for the initial stages of UC. At this point, the symptoms are mild and are not considered very risky. Some of the common types of 5-ASA drugs available right now are Mesalamine, Olsalazine, Sulfasalazine, and Balsalazide.
• Corticosteroids: If the 5-ASA drugs do not work and the symptoms do not seem to get better, doctors might opt for corticosteroids. These are prescribed for medium to severe cases of inflammation. They work by reducing the immune system’s activity. They can be had as oral pills or injected into the body. Some common side effects of this medication are oral thrush, difficulty in speaking, cough, and sore throat. Hence, they are not prescribed for long-term consumption and are used with caution.
• Immunomodulator drugs: These medications are prescribed for severe cases of UC. These drugs modify the response of the immune system and can both suppress and activate it. In this case, they are used for suppressing the system. A common problem with them is that they can bring down the general immune response of the body and can make the person susceptible to other kinds of infections and diseases. People on these drugs are generally monitored carefully by the doctors. Some common immunomodulator drugs are cyclosporine and tofacitinib .

Biologic drugs
Biologic drugs are those that use some parts of a living organism to treat a particular health condition. This concept is slowly gaining popularity everywhere in the world.

For UC, there are four FDA approved biologic drugs available.

• Humira
• Simponi
• Remicade
• Entyvio

All these work by targeting a protein called TNF Alpha (tumor necrosis factor-alpha), which causes inflammation in the body. This method of treatment is still under research.

Surgery
If your doctor thinks your symptoms are very severe and they are affecting your quality of life and your health, they can suggest surgery to remove the entire colon.

Some people bleed excessively because of UC, and in some others, the colon gets fully damaged because of the chronic nature of the disease. In both cases, the doctor can remove the colon completely and create a new passage for the wastes to reach the rectum. Studies say that when it comes to chronic UC, about 20% of people might need surgery at some point in life. However, surgery is always the last resort and is not suggested until the other treatments fail to work.

Natural remedies
Here are some of the most chosen natural remedies for UC. If your symptoms are very mild and the condition does not affect your quality of life or your health, you can try these out to keep a check on the inflammation.

People on medications can also choose these natural remedies along with their regular treatment processes after consulting their doctors.

• Probiotic supplements: Probiotics can help maintain your gut’s health. They are good bacteria that clean the digestive tract and prevent infections and digestive issues. Certain studies prove that probiotic supplements or foods rich in them can help combat the disease. You can also try out cultured milk enriched with strains of probiotic bacteria.
• Hypnosis: Though not approved as a treatment for UC, hypnosis done by the right expert can eventually calm down your body and mind. Stress is one of the conditions that flare up the disorder. By dealing with stress using hypnosis, you can end up bringing the inflammation levels down.
• Yoga and meditation: These are natural remedies that also help your body get rid of stress and negative thoughts. Stress usually increases the level of inflammation and can be combated by meditation. Stretching your body will also help you feel better and bring down the intensity of UC. Yoga is especially useful in this case.
• Acupuncture: Again, this traditional Chinese treatment method is not approved by the FDA but has shown promising results in a few studies. The acupuncture expert uses fine needles to restore balance in the body and improve blood flow. Both these are said to decrease inflammation and get rid of the body’s stress levels.
• Muscle relaxation techniques: Most of the abdominal pain caused by UC is because of the contraction of the colon. Muscle relaxation techniques teach you to relax your muscles and as a result, manage pain effectively.

Foods to have
Since UC is an inflammatory condition, the logical food choices that help manage the condition are those that are anti-inflammatory in nature, and those that help with general gut health.

• Aloe vera: Aloe vera is an excellent anti-inflammatory agent. You can remove the gel-like sap of the plant and consume it to help prevent inflammation. Do talk to your doctor before trying this out.
• Turmeric: Turmeric is a spice that is very popular in India, but is gaining ground in other places of the world too. This yellow root does wonders for any inflammation in the body. You can add turmeric to the food you prepare or add half a tablespoon of it to your milk. Curcumin, a chemical found in turmeric, is said to have the best anti-inflammatory properties. Curcumin is also said to prevent oxidative stress in the cells, preventing chronic damage to your intestine lining.
• Fish oil: Fish oil can also act as an anti-inflammatory ingredient. If you are a seafood lover, you can also skip fish oil and consume a lot of healthy and fatty fishes.
• Butyrate-rich foods: This short-chain fatty acid helps maintain your gut’s health and prevents digestive issues and controls inflammation. Foods like pure butter, clarified butter, goat’s milk, and almost all vegetables are rich sources of butyrate.
• Refined grains: People with this condition often find it difficult to handle high fibrous food. And whole grains are fiber-rich. Refined grains, on the other hand, are low in fiber and can be easily digested without triggering the symptoms of UC.
• Fully cooked fruits and vegetables: Raw fruits and vegetables are again high in fiber and can trigger the symptoms. It’s better if you can steam or boil them and then consume them. Skipping on fruits and veggies can make you nutrient-deficient. So, choose a wide variety of these and cook them well.
• Water: Staying hydrated is very important, whether your condition is flaring up or in remission. Water keeps the inflammation in control and also keeps the digestive tract healthy. You can choose water, clear broth, coconut water, or even rehydrating drinks to stay hydrated.

Remember that some foods work for some people better than others. Hence, you will fare better if you maintain a food diary. Write down foods that worked well for your system and those that triggered the condition. Over time, you will have your own customized lists of foods your body accepts and rejects.

Keep in mind that UC can easily be managed with the right medications, treatment choices, and the foods you eat. When you first start noticing signs of the condition, talk to your doctor about it. The earlier you handle it, the better will be your quality of life. Stay active, quit smoking, and cut down on your alcoholic intake too. All these can help prevent frequent flare-ups of the condition.