Ask the experts - Ulcerative colitis

We advise you to follow your Consultant’s recommendations and discuss with the consultant your wishes regarding your concerns.

what are the symtoms of ulcerative colitis
Dear Kim, Patients with ulcerative colitis can have specific and unspecific symptoms, in a milder or stronger way, including one, some, a combination of or all of the non exhaustive list below: • Abdominal pain and cramps • Bloody stools • Many thin stools with mucus • Frequent fever • Loss of weight and appetite Any of these symptoms should trigger a visit to the physician / GP and be subject to further tests.

When I was first diagnosed with bowel disease 20 years ago, my Doctor said I had Ulcerative colitis but now he’s saying I have Crohn’s disease instead. Is it possible that, over a period of time, Ulcerative colitis can change into Crohn’s disease?
- In certain cases it is almost impossible to differentiate between the two diseases. However, over a period of time, more information is gathered, with for example, coloscopy and this may then cause one to re-evaluate the first diagnosis. This should not be seen as a sign of changing the first diagnosis, but rather a reflection of how difficult it is to make a correct diagnosis in the first place.

My Doctor can’t tell me if I suffer from Crohn’s disease or Ulcerative colitis. Is it hard to differentiate between the two?
- In certain cases it can be impossible to differentiate Ulcerative colitis and Crohns. This applies only to the cases where the inflammation involves solely the large intestine (which is always the case with Ulcerative colitis and applies to 1/3 of Crohns patients). In 10 % of patients with inflammation contained within the large intestine, one cannot conclude if it is a matter of Ulcerative colitis or Crohns. These cases are often called Indeterminate Colitis.

Can stress cause Ulcerative colitis?
- As with many other chronic illnesses, stress can most probably aggravate symptoms with Ulcerative colitis. It may even be possible that stress, at certain times can lead to a relapse, but is in itself hardly a cause of the disease.

How great is the risk for an Ileostomy with Ulcerative colitis?
- There are today a number of surgical procedures, which can be performed to avoid the need for permanent Ileostomy. An Ileorectal anastomosis may be performed, in which the rectum is preserved and joined to the small intestine. Another operation uses a portion of the small intestine to form a small “pouch”, which is stitched to the anus. Both these procedures enable the patient to empty the bowels in the usual manner.

I have heard there is a need for a yearly coloscopy if one suffers from Ulcerative colitis.
- This is not the case with all patients, only those in which the entire large intestine is involved. The reason for regular coloscopy in these cases is the increased risk for colon cancer. These regular check-ups are not usually necessary until after the first ten years of the disease.