ULCERATIVE COLITIS

This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any medical condition. It aims to help you better understand gut-related issues, but the causes and diagnoses of these conditions are often complex and overlapping, with potential for misdiagnosis. This is why it’s essential to consult a qualified healthcare provider, such as a gastroenterologist or your doctor, for proper evaluation and advice tailored to your needs.

ULCERATIVE COLITIS

Ulcerative colitis (UC) is an Inflammatory Bowel Disease, a chronic condition where the immune system mistakenly attacks the digestive tract, causing ongoing inflammation. Ulcerative Colitis only affects the colon and rectum, in contrast to Crohn’s Disease which can affect any part of the gut.

This chronic, immune-mediated inflammatory disease, specifically affects the mucosal lining of the colon and rectum and unlike some other forms of inflammatory bowel disease (IBD), UC is limited to the large intestine and does not spread deeper into the bowel wall layers. It has been shown to be more common in people of European and Ashkenazi Jewish descent.

At its core, UC is believed to be driven by an overactive T-cell immune response directed against the body’s own intestinal flora (the gut microbiome).

Normally, the immune system tolerates friendly gut bacteria; however, in UC, this tolerance is lost. As a result, immune cells (particularly T-cells) produce excessive inflammatory mediators and interferons, leading to ongoing damage and inflammation of the gut lining.

UC always starts in the rectum and spreads upward — it never “skips” parts like Crohn’s disease does. Most cases are diagnosed between ages 15 and 35, but it can occur at any age. Untreated UC increases the risk of colon cancer, which is why regular screening colonoscopies are important.

FACTORS THAT INCREASE THE RISK OF UC:

Genetic predisposition (seen in twin studies)
Western diet (low fibre and high sugar)
Mental stress
Nicotine and smoking

SYMPTOMS:

Bloody diarrhoea (strongly associated with UC and a hallmark symptom).
Mucus in stool
Continuous mucosal lesions (as opposed to the patchy lesions found in Crohn’s).
Urgency to defecate (very common, especially when associated with bloody diarrhoea).
Abdominal pain/cramping (Often lower left side (colon area).
Rectal bleeding (Bleeding without external haemorrhoids is a major red flag).
Increased stool frequency (Often >6 times per day in moderate-to-severe UC).
Tenesmus (feeling like you still need to go, even after you’ve already gone).
Fatigue and weight loss (due to inflammation, anaemia, poor sleep).

COMPLICATIONS:

Colon Cancer (Colorectal Cancer) occurs after 8–10 years of active ulcerative colitis, especially if the entire colon is involved. Prevention requires regular colonoscopy screening to detect and remove precancerous changes early.
Severe Bleeding can occur from deep ulcers, leading to significant blood loss and anaemia. Management often requires iron supplementation, blood transfusions, or hospitalisation in critical cases.
Toxic Megacolon results from extreme inflammation causing rapid dilation and paralysis of the colon. Prevention focuses on aggressive treatment of flares, and emergency surgery is needed if early medical therapy fails.
Perforation (Colon Tear) happens when severe inflammation weakens the colon wall, leading to a life-threatening rupture. Prevention relies on early control of severe disease activity and prompt medical attention for worsening symptoms.
Primary Sclerosing Cholangitis (PSC) is a chronic liver disease linked to UC, where bile ducts become inflamed and scarred over time. There is currently no cure, but early detection through liver function tests and monitoring can slow disease progression and manage complications.

DIAGNOSIS

1. A colonoscopy with biopsy is the gold standard test to confirm ulcerative colitis as it lets doctor see the continuous inflammation and take a small tissue sample.

2. Flexible Sigmoidoscopy is useful if a colonoscopy can’t be completed as it allows the doctor to see the rectum and lower colon.

3. Stool Tests (e.g., Calprotectin, H. pylori stool test) as it can detect inflammation or rules out infections.

4. Blood Tests (CRP, ESR, Anaemia Panel) can show inflammation but is non-specific.

TREATMENT INDICATION

First-line treatment includes 5-ASA drugs for mild/moderate UC.
Immunomodulators (e.g., azathioprine) or biologics (anti-TNF, e.g., infliximab) are needed for moderate to severe disease.
Corticosteroids (e.g., prednisone) can be used for flare ups but should not be a long-term solution.
Surgery (Colectomy) is curative but only for very severe cases.

SUPPLEMENTATION RECOMMENDATION

REPOPULATING YOUR GUT MICROBIOME WITH THE RIGHT GOOD BACTERIA
Repopulating your gut microbiome with the right good bacteria to improve its function and role within your health will start resolving your symptoms.
Ensure you only take a probiotic that meets pharmaceutical grade standards to ensure efficacy and that dose delivery for symptom improvement, (uses gold-standard strains backed by clinical evidence for efficacy, with a minimum dose of 10 Billion CFU’s, protects it bacterial dose by ensuring shelf stability and full stomach acid protection with targeted delivery of the bacteria to your intestine, and meets all other quality metrics).The bacteria in your microbiome improves digestion and nutrient absorption, acts at the guts pharmacy – making vitamins, producing SCFA’s and other important metabolites, like serotonin. It is both the boss of and manager of our immune system. They Influence our brain and hormones, improve our mood + how our brain work. The microbiome also influence our Metabolic and Hormonal system/health.
HEALING THE WHOLE GUT SYSTEM, IMPROVING THE STRUCTURE, ENVIRONMENT AND FUNCTION
This condition can affect the gut structure, environment and function, leading to an overall decline in the performance of the whole gut system. This results in gut inflammation, increased oxidative levels altered colonic PH levels. It impairs; immune capabilities, cell function, barrier function, digestion and metabolic health. Which makes it harder for good bacteria to survive in your gut, and easier for pathogens to take over – leading to a negative-cyclical feedback loop that keeps you unhealthy, compromised and struggling with severe symptoms.

Probitec Intrinsic Bowel Support (30 capsules) and Probitec Gastro (10 capsules), have 8-strains and 20 Billion CFU’s, housed in the worlds most advanced probiotics capsule.

Probitec Fibre+ is a 3-in-1 formula of prebiotic fibre, glutamine and digestive enzymes, designed to enhance the composition and integrity of the whole gut system

The strains have over 120 studies confirming significant relief and improvement of the symptoms associated with the following:

Abdominal pain and discomfort
Diarrhoea, constipation
Bowel regularity and motility
Gas and bloating
Enhancing the gut-brain axis, reducing stress and improving mood
Improving Immunity and combatting pathogenic infections and overgrowth
Enhancing Intestinal Integrity
Reducing gut inflammation
Relieving GI distress or dysbiosis
Improving Quality of Life issues such as fatigue, brain fog and skin conditions.