Colon and Rectal Surgeons
of Kansas City

Ulcerative Colitis

Ulcerative colitis (U.C.) is felt to be an autoimmune disease in which the body attacks the lining of the colon and rectum causing inflammation and possible ulceration.  The most common symptoms of U.C. are diarrhea, abdominal pain, and rectal bleeding.  U.C. usually begins in the rectum and can advance upward to involve the entire colon.  U.C. is usually able to be treated medically.  The first line of medications is usually the mesalamine drugs, i.e. Azulfadine, Asacol, Lialda, Pentasa and Rowasa enemas.  Rowasa enemas are usually effective if the disease is confined to the rectum.  Immune suppressive drugs such as Prednisone and 6- Mescaptopurine are used for more advanced disease.  U.C. can be a mild disease requiring intermittent therapy, if severe and threatening, requiring surgery.

U.C. is more common in the Western society, as well as, people of Northern European or Jewish heritage.  However, all races and ethnicities can be affected.  There is a genetic predisposition, but there is also felt to be some type of environmental stimulus triggering the disease in individuals that have the predisposition.  U.C. tends to occur more commonly in younger individuals but all ages can be affected.  If the entire colon has been affected for over 10 years, the advance of cancer formation is 1-2% per year.  The type of cancer that is involved with U.C. is usually very aggressive.  Therefore all patients with U.C. should have close follow up with their gastroenterologist or colorectal surgeon.

Patients that are not responsive to medical therapy, have required multiple hospitalizations or are unable to wean off high dose steroid agents are candidates for surgery.  Surgery is curative of the disease.  (See J-Pouch procedures).  Surgery would entail removal of the entire colon and rectum either with a permanent ileostomy or without an ileostomy having a J-Pouch procedure.

For more information please visit:
The American Board of Colon and Rectal Surgeons
http://www.fascrs.org