What Is Ulcerative Colitis? – Causes, Symptoms & Diagnosis

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that affects the lining of the large intestine, colon, and rectum. It causes inflammation and ulcers in the innermost lining of the colon, leading to symptoms such as abdominal pain, diarrhoea (sometimes with blood and mucus), weight loss, fatigue, and urgency to have a bowel movement.

Inflammatory bowel disease (IBD) is a term mainly used to describe 2 conditions that cause inflammation of the gut (gastrointestinal tract). They are ulcerative colitis and Crohn’s disease.
IBD should not be confused with irritable bowel syndrome (IBS), which is a different condition and requires different treatment.

The exact cause of ulcerative colitis is not fully understood, but it is believed to be a result of a combination of factors, including genetic predisposition, immune system dysfunction, and environmental factors. The different types of ulcerative colitis include:

1. Ulcerative proctitis: This is the mildest form of UC, affecting only the rectum. Symptoms may include rectal bleeding, rectal pain, and a feeling of urgency.
2. Proctosigmoiditis: This type of UC involves inflammation of the rectum and the sigmoid colon, which is the lower part of the colon that connects to the rectum. Symptoms can include bloody diarrhoea, abdominal pain, and discomfort in the lower left part of the abdomen.
3. Left-sided colitis: This type affects the rectum, sigmoid colon, and descending colon, which is located on the left side of the abdomen. Symptoms may include bloody diarrhoea, abdominal cramping, weight loss, and pain on the left side of the abdomen.
4. Pancolitis: In this form of UC, the entire colon is affected, including the rectum, sigmoid colon, descending colon, transverse colon, and ascending colon. Symptoms can be more severe, including bloody diarrhoea, significant abdominal pain, fatigue, weight loss, and anaemia.
5. Fulminant colitis: This is a rare and severe form of ulcerative colitis, affecting the entire colon. It can lead to life-threatening complications, such as severe bleeding, toxic megacolon (a rapidly swelling colon), and perforation of the colon. Immediate medical attention is required in such cases.

In Traditional Chinese Medicine (TCM), ulcerative colitis is often classified under the category of “chronic diarrhoea” or “bloody dysentery” and is considered to be the result of an imbalance in the body. The diagnosis and treatment of ulcerative colitis in TCM are based on differentiating various patterns (also called syndromes) according to the symptoms and the patient’s overall health. Here are some common TCM patterns associated with ulcerative colitis and their respective treatment approaches:

1. Spleen Qi deficiency: This pattern is characterized by symptoms such as loose stools, fatigue, poor appetite, and abdominal pain. Treatment may involve herbal formulas and acupuncture to strengthen the spleen and improve digestion.
2. Damp-heat accumulation: This pattern presents with symptoms such as bloody stools, abdominal pain, fever, and a feeling of heaviness. The treatment focuses on clearing damp heat, cooling the blood, and alleviating pain. Herbal formulas and acupuncture are commonly used.
3. Liver Qi stagnation: Symptoms include abdominal pain, irritability, alternating diarrhoea, and constipation. The treatment aims to soothe the liver and regulate Qi, typically using a combination of herbal medicine and acupuncture.
4. Kidney Yang deficiency: This pattern is associated with symptoms such as loose stools, lower back pain, and cold limbs. Treatment focuses on warming and tonifying the Kidney Yang, often through herbal medicine and moxibustion.
5. Blood stasis: Symptoms include severe abdominal pain, bloody stools, and dark clots. Treatment aims to invigorate blood circulation and eliminate blood stasis, generally using herbal medicine and acupuncture.

It’s important to note that these patterns are not mutually exclusive, and patients may present with a combination of patterns. TCM practitioners may use a combination of herbal medicine, acupuncture, moxibustion, and dietary therapy to address the underlying imbalances.

Here is a reference for more information about TCM and ulcerative colitis:

Zhang, C., Jiang, M., & Lu, A. (2010). Considerations of Traditional Chinese Medicine as Adjunct Therapy in the Management of Ulcerative Colitis. Clinical Reviews in Allergy & Immunology, 38(2-3), 263-273. doi:10.1007/s12016-009-8139-x

https://www.nhs.uk/conditions/ulcerative-colitis/