Science is helping us learn more about ulcerative colitis (UC), a type of inflammatory bowel disease (IBD) that causes inflammation and small, open sores (ulcers) in the lining of your colon. IBD affects 3 million adults in the U.S., and more every year.
There’s no cure for UC, but ongoing research studies are giving us insight into what may cause the condition and new treatments for it.
UC Causes
Gut microbes. One major area of research is the link between inflammation and gut microbes. Our guts are home to a complex community of microbes that keep our immune system healthy.
Researchers at Stanford University have tied UC to a missing microbe. They compared two groups of people -- one with UC and the other with a rare illness that doesn’t cause inflammation. Researchers found that the people with UC lacked a certain type of bacteria and anti-inflammatory substances from bacteria called metabolites. If doctors can boost these metabolites in people with UC or build back the bacteria that make them, it could be a future UC treatment.
Other causes. Researchers are also exploring the connections between UC and:
- Genes
- Lifestyle factors like food, exercise, and smoking
- Things in the world around us like air pollution
- The immune system
UC Treatments
Prescription drugs. Most people with UC take prescription medicines to ease their symptoms. Scientists continue to research and develop new drugs. There are new immunotherapy medications that you can take by mouth, biosimilars (which are made to be similar to brand-name biologics), and some medications formerly for adults that are now approved for use in children with UC.
Complementary treatments. Beyond medications, other treatments show promise for UC:
- Fecal microbiota transplantation (FMT). During this procedure, doctors transfer stool from a healthy person to someone with an illness to boost helpful organisms. Right now, doctors mostly use FMT to treat C. diff infections, but early studies show it could also help people with UC.
- Probiotics. Studies suggest that helpful bacteria and yeasts that live in your body, called probiotics, may help treat and stop UC flares. Researchers have looked into different probiotics, and two show notable benefits: VSL#3 and Escherichia coli Nissle 1917.
- Stem cell therapy. Researchers continue to learn more about stem cells (human cells that can develop into different cell types) and have found they may work to treat inflammatory illnesses, including UC.
Researchers will need to do more studies on each of these possible UC treatments to confirm their results.
New Monitoring Techniques
Technology is also playing a role in UC diagnosis and tracking. Researchers are creating sensors that discover inflammation before you even have symptoms, which can signal a UC flare-up.
One is a “smart pill” that you swallow. It senses inflammation inside the body and sends a wireless signal to your smartphone or other devices. Researchers are also working on a wearable bracelet that spots inflammation-causing molecules called cytokines in your
sweat.
The American Gastroenterological Association recommends using non-invasive biomarkers rather than endoscopy for monitoring your ulcerative colitis. These three biomarkers provide accurate insights into your disease:
- Serum C-reactive protein (blood)
- Fecal calprotectin (stool)
- Fecal lactoferrin (stool)
If biomarkers are elevated, AGA suggests a follow-up endoscopy.
UC Outlook
Scientists are making progress in UC research, but there are still challenges. The number of people with UC is on the rise, and the reason for that isn’t clear. And there are research gaps in figuring out what causes the disease, especially on the effects of things in the world around us. The cost of UC care has also surged in recent years.
Experts are also tracking the financial impact of UC. Research from the Crohn’s & Colitis Foundation shows that in the U.S., people with IBD have three times higher medical fees than those without the illness. And they pay two times more in out-of-pocket medical costs. The biggest cost drivers are medications, emergency room visits, and treating other conditions that happen with IBD, like mental illness.
A long-term disease like UC can put serious financial, physical, and emotional strains on people with the condition. Stress isn’t a cause of UC, but it can trigger flare-ups of symptoms. Researchers say that addressing these issues will help improve the quality of life for people living with UC.
