Ulcerative Colitis

Classifying Ulcerative Colitis

In individuals with ulcerative colitis, a distinct portion of the colon is diseased. Disease starts at the rectum and moves “up” the colon to involve more of the organ. Doctors categorize ulcerative colitis by the amount of colon involved. Regardless of how little or how much of the colon is involved, symptoms can vary from mild to severe in any individual.

Types of ulcerative colitis are:

  • Ulcerative proctitisIf ulcerative colitis is limited to the rectum, it is known as ulcerative proctitis. Symptoms are diarrhea, bloody stool, pain in the rectal area, and a sense of urgency to empty the bowel.
  • ProctosigmoiditisIf ulcerative colitis affects the rectum and the sigmoid colon, it is known as proctosigmoiditis. Symptoms are diarrhea, bloody stool, cramps and pain in the rectal area, and moderate pain on the left side of the abdomen.
  • Left-sided colitis: Left-sided colitis affects the entire left side of the colon, from the rectum to the place where the colon bends near the spleen and begins to run across the upper abdomen (the splenic flexure). Symptoms include diarrhea, bleeding, weight loss and loss of appetite, and sometimes severe pain on the left side of the abdomen.
  • Pancolitis: If the entire colon is affected, the term pancolitis is used (“pan” meaning total). The classification is most important in planning treatment. While ulcerative proctitis, proctosigmoiditis, and even left-sided colitis can be treated with local agents introduced through the anus, including steroid-based or other enemas and foams, pancolitis must be treated with oral medication so that active ingredients can reach all of the affected portions of the colon.

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