Ulcerative colitis (UC) is an inflammatory bowel disease that is affecting more and more people worldwide. Because the management of this chronic gastrointestinal disorder has become more complex, The American College of Gastroenterology has updated its guidelines in both diagnosis and treatment. The guidelines had previously been untouched for 10 years. Now that new therapies, medications, and techniques are available, the guidelines support a goal for each ulcerative colitis patient to reach steroid-free remission. The guidelines also emphasize a reduced risk for hospitalization, surgery, and cancer. At GI Associates & Endoscopy Center, we are dedicated to educating you on the new guidelines as well as giving you the best treatment so you can have a normal quality of life.

Ulcerative Colitis Explained

Ulcerative colitis causes chronic inflammation and ulcers along your digestive tract. Symptoms include diarrhea, an urgency to have a bowel movement, rectal pain, abdominal pain, and cramping. Rectal bleeding—passing blood along with a stool—is another common symptom of ulcerative colitis. Fever, fatigue, and weight loss may also indicate this facet of inflammatory bowel disease. The severity of ulcerative colitis varies from person to person, but the symptoms can often cause emotional stress and insecurity. Ulcerative colitis is a chronic disease with no known cure, but treatment can reduce the frequency of symptoms and even lead to a period of time where no symptoms are evident.

New Diagnosis Guidelines

Patients who experience rectal bleeding and frequent bowel movements should immediately be considered for ulcerative colitis. Various infectious causes should not be considered as they have in the past. A lower gastrointestinal endoscopy and histologic confirmation are required in order to determine the extent of the disease. The range of severity has also been altered. Patients will now be diagnosed as having mild, moderate to severe, or fulminant ulcerative colitis. Those with mild ulcerative colitis are said to have less than four bowel movements each day with intermittent rectal bleeding. Moderate to severe ulcerative colitis is defined as passing more than six stools a day with frequent rectal bleeding. Ulcerative colitis categorized as fulminant means the patient has more than 10 bowel movements in a day and requires blood transfusions.

New Treatment Goals

A season of remission, where no symptoms are experienced, has always been the main goal for gastroenterologists treating ulcerative colitis patients. Along with remission, new goals include symptom control and normalizing the frequency of bowel movements. Ulcerative colitis is a chronic condition, so treatment will be ongoing. New treatment plans should prevent treatment-related toxicity, as well as address depression and anxiety that is common in ulcerative colitis patients. If rectal therapies do not lead a patient into remission, oral steroids are prescribed. In the event that hospitalization is needed for a severe case of ulcerative colitis, special testing and medication are required before surgical measures are taken. Surgery is reserved for special cases with serious complications. 

Another goal in ulcerative colitis treatment is to prevent colorectal cancer. Now, a colonoscopy is recommended for ulcerative colitis patients eight years after they are diagnosed. Screening should occur every one to three years depending on the severity of ulcerative colitis, and whether or not other risk factors are present. GI Associates & Endoscopy Center has three convenient locations with a staff dedicated to your gut health. We have even opened an IBD clinic to better serve our ulcerative colitis patients. 

If you have concerns about ulcerative colitis or want to revisit your treatment plan under the new guidelines, make an appointment with us today.

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