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Ulcerative Colitis 101

Our medical expert untangles the facts about ulcerative colitis.
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What Causes Colitis?

Although the cause is unknown, finding the culprit remains an important area of research, starting with genetics -- about 15% of patients with the disease have a close family member who also lived with an IBD.

Another suspect is the body’s immune system, with some evidence indicating UC could be an autoimmune disease. “The body’s own immune system can overreact to a trigger that prompts it to kick into high gear,” says Esrailian. “As a result, a person develops the symptoms and signs of UC, which does lead us to believe an autoimmune component may be at play.”

Stress doesn’t cause ulcerative colitis, but research shows it can increase the risk of flare-ups. “If someone isn’t sleeping because of stress and becomes ill from a viral illness, for example, that can lead to a flare because it can stimulate the immune system, which triggers inflammation, and leads to symptoms,” says Esrailian.

But again, the typical effects of stress on the GI tract are different than the true symptoms of UC, explains Esrailian. While a rough day at the office might cause bloating and a stomachache, for instance, that doesn’t mean it’s a flare -- it just means you’re not treating your body as well as you could. 

Treating Colitis

Treating UC means finding a drug therapy that works for you. “Whatever therapy you’re on, it’s considered maintenance, meaning you have to take it to control symptoms, and as soon as you stop, your symptoms can return,” Esrailian says.

Treatments for UC are primarily oral or topical. “Generally, a mainstay treatment is a class of drugs called 5-aminosalicylates, which have an anti-inflammatory effect on the bowel to help minimize flare-ups,” Esrailian explains.

Another class is the immunomodulators, which suppress the immune system to calm any unnecessary activity in the bowel. Biologic agents are another option for more severe disease, as are corticosteroids in the short-term.

While the Internet touts treatments such as probiotics, omega-3 fatty acids, and herbal remedies like boswellia -- a gum resin from the boswellia tree -- the scientific research hasn’t quite caught up. “There’s not a lot of clear evidence because alternative therapies are not rigorously studied,” says Esrailian. “While limited evidence does show probiotics might be beneficial, for instance, more research is necessary before they can be recommended widely.”

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