We’ve all experienced stomach pains – maybe after eating something too spicy or greasy. You may have even had food poisoning that left you with diarrhea and stomach cramps. Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD) that also affects your digestive system, but the diarrhea, rectal bleeding, and abdominal cramps from UC are from inflammation and ulcers inside the digestive tract.
In North America, about 1.5 million people have UC.1 Once seen as a disorder that primarily affected people of European ancestry, the demographic of people with UC is rapidly changing. Studies show that Hispanic people have more extensive inflammation in the colon compared to white people, and UC symptoms present differently in Black people.2,3 In this article, we will go over five things to know including: what it is, signs and symptoms, causes, dietary changes, and the affect of UC on the Black community.
1. What is Ulcerative Colitis?
Ulcerative colitis (UC) is a chronic autoimmune disease that causes inflammation and ulcers on the inner lining of the large intestine (colon and rectum) which can result in damage of the entire large intestine.4,5 Inflammation from UC weakens the walls of the colon. These weak areas create open sores, called ulcers. UC and Crohn’s disease are both types of inflammatory bowel diseases (IBD), but ulcerative colitis is the most common type of IBD. 2,3,4 Anyone can be affected by ulcerative colitis but it is known that people between the ages of 15 and 30 or up age 40 years are more likely to develop this disorder.1,5
If you have ulcerative colitis, you may have blood or mucus in your stool and feel an urgent need to empty your bowels. People with ulcerative colitis also have nearly 2 times the chance of developing colon cancer than the general population.1
2. Signs and Symptoms of Ulcerative Colitis
Some of the signs and symptoms of ulcerative colitis (UC), like diarrhea, can look similar to the symptoms of Crohn’s disease. Other symptoms are unique. If you think you may have any of these symptoms, you should see your doctor to confirm if you do or don’t have ulcerative colitis. In UC, you may have periods of remission (when symptoms disappear) and relapse (when symptoms can return). Remission can last for weeks or years.5
Here are some of the unique symptoms you may see in ulcerative colitis: 4,5
- Having stool (poop) with blood
- Having stool with mucus
- Stomach cramping with bowel movements
- Urgent need to have a bowel movement even though your bowel may be empty
Symptoms of UC may be mild or severe. If your symptoms are mild, you may have less than 4 bowel movements a day, and you may not have blood with each stool. If you have severe symptoms, you may have more than six bowel movements each day with most of them containing blood. If you have very severe ulcerative colitis, a rare form of UC, you may have more than 10 bloody bowel movements a day.5
Symptoms seen in more severe cases include5:
- Fatigue
- Fever
- Nausea or vomiting
- Weight loss
3. Causes of Ulcerative Colitis
The exact cause of UC is unknown but researchers think genetics, abnormal immune reactions, bacteria in the digestive tract, and the environment may play a role in the disease development.6,7
4. Can Ulcerative Colitis be Prevented?8
If you have a close family relative with ulcerative colitis (UC), your chances of developing the disease are increased. Up to 20% of people with irritable bowel disease have a first-degree relative, but it can also happen in people without a family history. Experts don’t know how to prevent ulcerative colitis since they aren’t exactly sure what causes the disease. If you have UC, there may be some changes you can make to your diet to help reduce the symptoms.
Here are some recommended dietary changes:
- Avoid drinking carbonated drinks
- Eat more frequent, smaller meals that are gut-friendly
- Keep a food diary that helps you identify foods that cause symptoms
- Avoid eating high-fiber foods like popcorn, nuts, or vegetable skins while you have symptoms
- Drink more liquids
Your doctor may also recommend that you avoid taking anti-inflammatory medications, like ibuprofen or naproxen. These medications may make you have flare-ups.
It may also be recommended that you keep your gut healthy by adding probiotics to your diet. Probiotics replenish the gut microbiome – the “good bacteria” found in your digestive tract that help aid in digestion and immunity. Part of our gut microbiome can become disrupted by certain foods and medications.9
5. How Does Ulcerative Colitis Affect Black Communities?
Ulcerative colitis (UC) is more commonly seen among White people and people of Jewish descent than it’s seen in Asian or Black people.7,8 Some research has found that the way that ulcerative colitis appears in Black people varies from the way the symptoms appear in non-Black people.
One study found significantly lower rates of inflammation in the rectum in Black and Hispanic people with UC when compared to white people with UC.3 Another study reports an increased rate of arthritis and inflammation in the joints associated with Black people who have ulcerative colitis.3 A barrier found for Black people is a delay in diagnosis, which can lead to poor outcomes. This delay is attributed to several factors including limited access to specialists and understanding of UC.3
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References
- Journal of the American Medical Association (2024) What is Ulcerative Colitis https://jamanetwork.com/journals/jama/fullarticle/2814797 Accessed August 27, 2024
- Barnes Edward L et al (2021) Effects of Race and Ethnicity on Diagnosis and Management of Inflammatory Bowel Diseases https://www.gastrojournal.org/article/S0016-5085(20)35312-9/fulltext Accessed August 27, 2024
- Florence-Damilola O et al. (2022) Inflammatory Bowel Disease in Underserved Populations: Lessons for Practice https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332404/ Accessed August 27, 2024
- US Centers for Disease Control and Prevention (2024) Ulcerative Colitis Basics https://www.cdc.gov/inflammatory-bowel-disease/about/ulcerative-colitis-uc-basics.html Accessed August 27, 2024
- National Institute of Diabetes and Digestive and Kidney Diseases (2020) Ulcerative Colitis https://www.niddk.nih.gov/health-information/digestive-diseases/ulcerative-colitis Accessed August 27, 2024
- National Institute of Diabetes and Digestive and Kidney Diseases (2020) Symptoms and Causes of Ulcerative Colitis https://www.niddk.nih.gov/health-information/digestive-diseases/ulcerative-colitis/symptoms-causes Accessed August 28, 2024
- National Organization for Rare Disorders (2012) Ulcerative Colitis https://rarediseases.org/rare-diseases/ulcerative-colitis/#causes Accessed August 28, 2024
- Cedars Sinai (2024) Ulcerative Colitis https://www.cedars-sinai.org/health-library/diseases-and-conditions/u/ulcerative-colitis.html Accessed August 28, 2024
- US Department of Agriculture (2024) Keeping a Healthy Gut https://www.ars.usda.gov/oc/utm/keeping-a-healthy-gut/ Accessed August 28, 2024
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