Ulcerative Colitis

What is ulcerative colitis?

Ulcerative colitis is an inflammation in the lining of the large intestine (colon) and the rectum. It may be caused by a problem with the immune system. The immune system is the body's way of fighting infection. Emotional distress or sensitivity to certain foods may trigger symptoms in some people who have colitis. The symptoms include belly pain and diarrhea, often bloody, that usually comes and goes.

What can I expect in the hospital?

You may need to stay in the hospital because:

• You have a medical condition which is making your ulcerative colitis worse
• You have symptoms of ulcerative colitis which need immediate treatment or an adjustment to your treatment
• You have chosen to have surgery to treat ulcerative colitis

Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:

Monitoring

• You will be checked often by the hospital staff.
• Your heart rate, blood pressure, and temperature will be checked regularly.
• A heart (cardiac) monitor may be used to keep track of your heartbeat.
• Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
• Your fluid intake may be monitored closely by keeping track of everything you eat and drink and any IV fluids you receive.
• Your fluid output may be monitored closely by keeping track of the amount of urine and bowel movements you produce. You may have a small tube (catheter) placed into your bladder to drain and measure urine.
• Testing

Testing may include:

• Blood tests to check for infection and blood loss
• Tests of bowel movements to check for infections or blood
• Barium enema: An X-ray is taken of your belly after contrast dye is inserted through your rectum to show the walls of the intestine and any possible problems.
• Sigmoidoscopy or colonoscopy: A test is done in which a thin, flexible tube and tiny camera is put into your rectum and up into the colon to look for causes of the pain or bleeding. Sometimes one or more pieces of tissue are removed to help make a diagnosis. This is called a biopsy.
• X-rays: Pictures of the inside of the belly to check for abnormalities
• Computed tomography (CT) scan: A series of X-rays is taken from different angles and arranged by a computer to show thin cross sections of the belly or pelvis.

Treatment

The treatment for ulcerative colitis depends on your symptoms, how well you respond to treatment, your overall health, and any complications you may have.

• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
• If you have lost a lot of blood, you may need a blood transfusion.
• You may have a tube put through your nose down into your stomach, called a nasogastric or NG tube. The tube may be used to give fluids or medicine, or with suction to help relieve pressure from air or fluids in your stomach and intestine.
• Your provider may prescribe medicines or other therapy to:
  • Treat or prevent infection
  • Reduce inflammation in the colon
  • Prevent your immune system from attacking healthy cells
  • Treat pain
  • Treat and prevent diarrhea
  • Treat anemia from blood loss
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.
• You may need surgery to treat ulcerative colitis. Surgery involves removing the entire colon and rectum. The upper, healthy part of the intestine is attached to an opening in the wall of your belly (ileostomy). Bowel movements then pass through this opening instead of the rectum. They are collected in a bag outside the body.
• You may need a special diet high in protein and calories.

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Bright red blood in your bowel movement with diarrhea
  • Severe bleeding from your ileostomy site
  • Bloating or belly pain
  • Diarrhea, constipation, or other intestinal problems
• Symptoms of dehydration, which may include dry mouth or eyes, weakness, little to no urine output
  • Signs of infection around your surgical wound if you had surgery. These include:
    • Redness, swelling, or leaking around your ileostomy site
    • The wound area is very warm to touch or painful
    • You have blood, pus, or other fluid coming from your wound area
    • You have chills or muscle aches
• Ask questions about any medicine or treatment or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many things, such as your general health, why you are in the hospital, and the treatment you need. The average amount of time to stay in the hospital for ulcerative colitis is 4 to 6 days. Talk with your provider about how long your stay may be.