Diagnosis and Treatment of Ulcerative Colitis

How is Ulcerative Colitis Diagnosed?

Your doctor may complete a physical exam to check for the common signs and symptoms of UC (bleeding from the rectum, diarrhea, fever, weight loss), and also review your medical history to determine if UC runs in your family.

If your physician is suspicious that UC may be the reason for your symptoms, he or she may order a series of tests to confirm those suspicions. Some important tests that your doctor may order are:

• Laboratory Workups Your doctor may take blood and stool samples. A blood test can detect anemia, which occurs when the concentration of hemoglobin, the protein that carries oxygen in the blood, is below normal. The blood test will also detect any vitamin, mineral and electrolyte deficiencies.
• Sigmoidoscopy This test is a visual examination of part of the colon and rectum. An instrument with a light source at one end will be inserted into your rectum to detect any areas of bleeding and ulcerations that may exist.
• Colonoscopy Similar to the sigmoidoscopy examination, colonoscopy also requires that an instrument with a light source be inserted into the rectum. With this test, more of the large intestine can be observed. Some devices have the ability to take a tissue sample, take pictures of your intestine or allow your doctor to perform minor surgery.
• Barium Enema The barium enema includes a substance called barium sulfate, which is pumped into the large intestine through the anus, to allow the colon to be visualized. An X-ray is then taken of the large intestine to reveal any abnormalities in its shape and surface.

How Is Ulcerative Colitis Treated?

Currently, there is no cure for UC, except through surgical removal of the colon. However, symptoms often can be controlled by anti-inflammatory medications prescribed by your doctor.

Once your doctor has confirmed that you indeed have ulcerative colitis, he or she will evaluate treatment options with you.

Some types of medications that your doctor may prescribe include:

• Aminosalicylates (5-ASAs) These are aspirin-like drugs that help to control the inflammation that occurs during a flare-up. Examples of these medications include balsalazide, mesalamine, olsalazine and sulfasalazine.
• Corticosteroids Corticosteriods, such as prednisone and methylprednisolone, are also anti-inflammatory medications; however, they are typically reserved for more severe cases of UC. Corticosteriods are not recommended for long-term use due to the side effects that may occur.
• Immunosuppressants These medicines (given orally) include azathioprine, 6-mercaptopurine (6-MP) and cyclosporine. Immunosuppressants are usually given to patients who do not respond well to aminosalicylates or corticosteroids.

Follow Your Doctor's Orders

To help keep your UC under control, it is important that you adhere to your physician's orders and continue taking your medication as prescribed. Taking your medication on time, in the right amount and for the duration of therapy helps ensure that your illness does not recur or evolve into a more serious medical problem.