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Ulcerative Colitis

A disease that causes ulcers and irritation in the inner lining of the colon and rectum.

PubMed Health Glossary
(Source: NIH - National Institute of Diabetes and Digestive and Kidney Diseases)

About Ulcerative Colitis

Ulcerative colitis is a chronic, or long-lasting, disease that causes inflammation and sores, called ulcers, in the inner lining of the large intestine, which includes the colon and the rectum - the end part of the colon.

UC is one of the two main forms of chronic inflammatory disease of the gastrointestinal tract, called inflammatory bowel disease (IBD). The other form is called Crohn's disease.

Normally, the large intestine absorbs water from stool and changes it from a liquid to a solid. In UC, the inflammation causes loss of the lining of the colon, leading to bleeding, production of pus, diarrhea, and abdominal discomfort... NIH - National Institute of Diabetes and Digestive and Kidney Diseases

What works? Research summarized

Evidence reviews

Fish oil for the treatment of active ulcerative colitis

Ulcerative colitis is an inflammation of the large intestine that causes diarrhea, abdominal pain, rectal bleeding and fever. Since there is no cure for the disease the aim of treatment is to cause a reduction of the unpleasant and painful signs and symptoms. Current, proven, treatment options for active ulcerative colitis include corticosteroids, aminosalicylates, immunosuppressive and biological agents. However, these drugs can cause side effects. New treatments which cause fewer side effects are being sought. Fish oil, which is rich in omega‐3 fatty acids may reduce inflammation and decrease the need for anti‐inflammatory drugs in patients with ulcerative colitis. Six studies looking at the effects of fish oil in active ulcerative colitis were included in the review. Study quality was mostly poor. One small study showed a positive benefit for the treatment of active ulcerative colitis. However, this result should be interpreted with caution due to small study size and poor study quality. Due to limited data there is not enough information available to determine whether fish oil treatment is effective for induction of remission in ulcerative colitis.

Omega 3 fatty acids for maintenance of remission in ulcerative colitis

Fish oil contains omega 3 fatty acids that may be beneficial in reducing inflammation, such as seen in the bowel of ulcerative colitis patients. Randomized placebo‐controlled studies that evaluated the effect of daily intake of omega‐3 fatty acids to maintain remission in ulcerative colitis were reviewed. Three studies were included of which none reported a reduction in the rate of disease relapse in comparison with placebo. When the studies were pooled for meta‐analysis there was no benefit for omega 3 fatty acids. There were no serious side effects in any of the studies. None of the studies used enteric coated capsules which allow release of the fish oil in the small bowel. Non‐enteric coated omega‐3 fatty acids (fish oil) seem safe but ineffective for maintaining remission in ulcerative colitis. Further studies of enteric coated capsules may be justified.

Open versus laparoscopic approach to pouch surgery in patients with ulcerative colitis and familial adenomatous polyposis showed no significant differences in mortality and complications, but the laparoscopic approach resulted in better cosmesis.

Resection of the entire colon and creation of an ileal pouch by means of an ileo pouch anal anastomosis (IPAA) is a last resort for many patients with ulcerative colitis and familial adenomatous polyposis. In recent years this operation has increasingly being performed laparoscopically. In this review we compared the open versus laparoscopic IPAA. We found no significant differences in mortality and complications between the two techniques. The laparoscopic IPAA had a longer operative time of on average 90 minutes. No reliable conclusions could be made regarding the benefit of laparoscopic IPAA on the postoperative recovery. Findings suggest that the laparoscopic approach may improve the postoperative recovery, but the importance of these advantages seems limited. The laparoscopic IPAA did result in better cosmesis than the open IPAA, but more studies will be needed to confirm these findings.

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Summaries for consumers

Fish oil for the treatment of active ulcerative colitis

Ulcerative colitis is an inflammation of the large intestine that causes diarrhea, abdominal pain, rectal bleeding and fever. Since there is no cure for the disease the aim of treatment is to cause a reduction of the unpleasant and painful signs and symptoms. Current, proven, treatment options for active ulcerative colitis include corticosteroids, aminosalicylates, immunosuppressive and biological agents. However, these drugs can cause side effects. New treatments which cause fewer side effects are being sought. Fish oil, which is rich in omega‐3 fatty acids may reduce inflammation and decrease the need for anti‐inflammatory drugs in patients with ulcerative colitis. Six studies looking at the effects of fish oil in active ulcerative colitis were included in the review. Study quality was mostly poor. One small study showed a positive benefit for the treatment of active ulcerative colitis. However, this result should be interpreted with caution due to small study size and poor study quality. Due to limited data there is not enough information available to determine whether fish oil treatment is effective for induction of remission in ulcerative colitis.

Omega 3 fatty acids for maintenance of remission in ulcerative colitis

Fish oil contains omega 3 fatty acids that may be beneficial in reducing inflammation, such as seen in the bowel of ulcerative colitis patients. Randomized placebo‐controlled studies that evaluated the effect of daily intake of omega‐3 fatty acids to maintain remission in ulcerative colitis were reviewed. Three studies were included of which none reported a reduction in the rate of disease relapse in comparison with placebo. When the studies were pooled for meta‐analysis there was no benefit for omega 3 fatty acids. There were no serious side effects in any of the studies. None of the studies used enteric coated capsules which allow release of the fish oil in the small bowel. Non‐enteric coated omega‐3 fatty acids (fish oil) seem safe but ineffective for maintaining remission in ulcerative colitis. Further studies of enteric coated capsules may be justified.

Open versus laparoscopic approach to pouch surgery in patients with ulcerative colitis and familial adenomatous polyposis showed no significant differences in mortality and complications, but the laparoscopic approach resulted in better cosmesis.

Resection of the entire colon and creation of an ileal pouch by means of an ileo pouch anal anastomosis (IPAA) is a last resort for many patients with ulcerative colitis and familial adenomatous polyposis. In recent years this operation has increasingly being performed laparoscopically. In this review we compared the open versus laparoscopic IPAA. We found no significant differences in mortality and complications between the two techniques. The laparoscopic IPAA had a longer operative time of on average 90 minutes. No reliable conclusions could be made regarding the benefit of laparoscopic IPAA on the postoperative recovery. Findings suggest that the laparoscopic approach may improve the postoperative recovery, but the importance of these advantages seems limited. The laparoscopic IPAA did result in better cosmesis than the open IPAA, but more studies will be needed to confirm these findings.

See all (41)

Terms to know

Colon (Bowel)
The longest part of the large intestine, which is a tube-like organ connected to the small intestine at one end and the anus at the other. The colon removes water and some nutrients and electrolytes from partially digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus.
Gastrointestinal Bleeding
Bleeding in any segment of the gastrointestinal tract.
Gastrointestinal Tract (GI Tract)
The large, muscular tube that extends from the mouth to the anus, where the movement of muscles, along with the release of hormones and enzymes, allows for the digestion of food. Also called the alimentary canal or digestive tract.
Large Intestine
The part of the intestine that includes the appendix, cecum, colon, and rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long.
Rectum
The last several inches of the large intestine closest to the anus.
Ulcers
A sore on the skin's surface or on the stomach or intestinal lining.

More about Ulcerative Colitis

Photo of a young adult

Also called: Chronic ulcerative colitis, Colitis gravis, UC

See Also: Crohn's Disease

Other terms to know: See all 6
Colon (Bowel), Gastrointestinal Bleeding, Gastrointestinal Tract (GI Tract)

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