Ulcerative Colitis

You might feel embarrassed to talk about your bowel problems. We know it can be uncomfortable. But it’s important to bring them up during your first visit. Our providers know how to recognize the signs of ulcerative colitis when you’re talking about digestive symptoms and confirm an accurate diagnosis.

During your visit, we’ll ask you about your personal and family medical history and symptoms. We’ll also likely have you give us a stool (poop) sample so we can check it for signs of infection or inflammation. As gross as it might sound, your poop can tell us a lot about what’s happening in your gut.

Your provider might also decide that you’ll need lab work. This lets us look at your blood for signs of inflammation, like anemia. Your provider might order imaging tests like a CT scan or MRI to take pictures of your intestines. This gives us a closer look to see if you have inflammation.

After these tests, our gastroenterologists will schedule you for a diagnostic colonoscopy. We’ll use a long tube with a camera in your intestines to look at your colon for signs of UC. Don’t worry, you’ll be sedated and likely asleep during the test.

Without treatment, UC can cause serious damage to your digestive system. Early diagnosis usually means that you’ll have more treatment options and lower risks of complications. Complications can include long-term damage to your colon’s lining or colon cancer. Your treatment options for ulcerative colitis can vary depending on the nature and severity of your symptoms.

Nonsurgical treatments

For mild or moderate UC, we start by prescribing medications. Ulcerative colitis medications can:

• Control symptoms like diarrhea, bleeding and abdominal pain.
• Help heal the tissues in the lining of your colon.
• Limit inflammation in your colon.
• Suppress your immune system if an immune reaction is causing inflammation.
• Prevent complications.

We conduct clinical trials to test the latest treatments, including medications for UC. You may be eligible for a clinical trial for a new medication that isn’t widely available at other hospitals. Your provider can talk with you about this option.

In addition to medications, your provider might also suggest seeing our specialized IBD nutritionists for diet changes to help you better manage your symptoms. While the food you eat doesn’t cause UC, certain foods could make your symptoms worse. Changing what you eat can help your body get the nutrients it needs. Your provider may also have you see our IBD psychology team for help with coping with this chronic disease.

Surgery

If medications don’t relieve your symptoms, you have a more severe form of UC or develop complications, we might recommend surgery. We use minimally invasive techniques (including laparoscopic and robotic surgery) whenever possible to reduce pain and scarring and to speed up your recovery time.

Often, our surgeons will remove your colon and rectum (proctocolectomy) or only your colon (colectomy). Surgeons change your gastrointestinal tract’s pathway. Picture how a plumber re-routes a pipe. Instead of fitting together the way it originally did, one part of the pipe now connects in a new spot. This means you will have either an internal pouch or external bag to collect stool. Two options for this are:

• J-pouch surgery: Surgeons construct an internal pouch (a J-pouch) inside your body to store stool until you’re ready to release it the normal way. Most people with a J-pouch move their bowels seven times per day, but without any urgency or bleeding like with UC.
• Ileostomy: Surgeons make an opening that connects to a bag outside your body. The ileostomy allows stool to pass from your body into the ostomy bag, which you empty throughout the day, typically around six times.

Symptoms of ulcerative colitis can sometimes return after surgery. Your provider can prescribe medications to reduce inflammation and minimize the risk of it coming back. Our surgeons also can do revision surgery if you need additional treatment after your first surgery. At Cleveland Clinic, we are very experienced at revisions and can help you if this is what you need.

Taking the Next Step

Intestinal issues like ulcerative colitis can be embarrassing — and hard to talk about. And, worse, they can leave you constantly running to the bathroom and doubled over in pain. No one needs to live this way. Cleveland Clinic is here to help you get relief from your ulcerative colitis and feel comfortable leaving the house again. We want you to live life to the fullest.