Types of Ulcerative Colitis

Ulcerative colitis (UC) can affect different parts of your colon and rectum. There are three main types of UC and each can have different symptoms. The intensity of your condition depends on the amount of inflammation and the area affected. It’s important to know which type of UC you have and how it may affect your health.

Ulcerative Proctitis

This type of UC affects about one-third of people with the disease. With ulcerative proctitis, bowel inflammation only happens in your rectum, which is the last part of your large intestine. Usually, this disease affects less than 6 inches of your rectum. Ulcerative proctitis isn’t linked to a higher risk of cancer.

Symptoms of ulcerative proctitis usually includes pain in your rectum, bleeding in your rectum, and a sudden need to go poop.

Doctors usually use a therapy called rectal 5-ASA to treat ulcerative proctitis. It can be a suppository or in an enema. If you don’t respond well to rectal 5-ASA, the doctor will give you rectal steroids either with rectal 5-ASA or by themselves.

If this still doesn’t work, they’ll give you oral 5-ASA or sulfasalazine, a drug for UC. You might take it alone or with a rectal therapy. If none of these treatments helps your condition, you’ll take oral steroids.

Left-Sided Colitis

This form of UC can cause inflammation anywhere from your rectum all the way to the splenic flexure of your colon, which is the bend near your spleen. This condition includes proctosigmoiditis, which affects your rectum and sigmoid colon, the lower part of your colon above your rectum.

This condition could cause a loss of appetite, weight loss, pain on the left side of your belly, or bloody diarrhea.

Doctors treat left-sided colitis with rectal corticosteroids and 5-ASA. They may use these therapies alone or with oral 5-ASAs.

Extensive Colitis (Pancolitis)

This type of UC affects your entire colon. Inflammation starts at your rectum and goes beyond your splenic flexure.

Symptoms might include bloody diarrhea, pain in your belly, lack of appetite, weight loss, fever, and cramps.

If you have pancolitis, you’ll most likely need both oral and topical 5-ASA alongside corticosteroid treatment.

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Lifestyle Tips

In addition to treatment, you can make lifestyle and diet changes to help avoid UC problems:

Diet. Five or six smaller meals instead of three larger meals a day may prevent UC symptoms from getting worse. If you have a flare-up, a temporary low-fiber diet might ease some of your pain. These types of diets lower the number of times you need to poop. They center on foods like white bread, white rice, white pasta, eggs, lean meat and fish, vegetables, and refined cereals. Always talk to your doctor before you start a new diet.

Supplements. You might not have enough vitamins or minerals in your diet. Ask the doctor if you should be taking any food supplements.

Hydration. Diarrhea can make you lose a lot of fluid. It’s important to drink enough water and limit caffeine, alcohol, and fizzy drinks which could give you gas.

Stress. It can worsen your UC symptoms. Exercise often, get at least seven hours of sleep a night, and find ways to relax every day.

Medications. If you need a pain reliever, take acetaminophen (Aceta, Panadol, Paracetamol, Tylenol) instead of ibuprofen (Advil, IBU, Motrin). These could trigger UC flare-ups. Antibiotics might make your UC symptoms worse, too. Tell your doctor about all the medications you take to make sure they don’t interfere with your condition.

WebMD Medical Reference Reviewed by Michael W. Smith, MD on February 03, 2021

Sources

SOURCES:

Crohn’s & Colitis Foundation: “Types of Ulcerative Colitis.”

Cleveland Clinic: “Ulcerative Colitis,” “Ulcerative Colitis: Prevention.”

Johns Hopkins Medicine: “Ulcerative Colitis: Introduction.”

National Cancer Institute: “Rectum.”

Clinics in Colon and Rectal Surgery: “Ulcerative Proctitis.”

Inflammatory Bowel Diseases: “Medical management of left-sided ulcerative colitis and ulcerative proctitis: Critical evaluation of therapeutic trials.”

American Academy of Family Physicians: “Ulcerative Colitis: Diagnosis and Treatment.”

NHS: “Living with Ulcerative Colitis.”

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