Ulcerative colitis (UC) is a condition, which involves inflammation and ulceration of the lining of the large intestine, medically called as colon. (Colitis= inflammation of colon). The digestive System is a system of organs responsible for digesting the food we eat so that nutrients in the food are available to body to provide required energy. The digestive System consists of a long tube, which connects the mouth to the anus. Once food leaves the mouth, it enters the part of the GI tract called the esophagus and then the stomach. In the stomach food pauses for sometime and is mixed up with acid and juices present in the stomach. It then passes into the small intestine, which measures about 20 feet in length. The small intestine has three parts; the part nearest the stomach is the duodenum, the next part is the jejunum and the third part that connects to the large intestine is the ileum. Small intestine is the site where most of the food is digested with the assistance of secretions from the liver, gall bladder, and pancreas. The nutrients from this digested food are then absorbed through small intestine. Followed by the small intestine is the large intestine, which is more frequently referred to as the colon. The large intestine (colon) is  6-7 feet in length. The first part of the colon is called the caecum and the appendix is found there. The caecum and appendix are situated in right lower portion of the abdomen. Large intestine then extends upward (this portion being called as ascending colon), then takes a turn and passes across (portion called as transverse colon) and then goes down wards (descending colon). At the end of descending colon, portion of large intestine which look like alphabet S is called as sigmoid colon which opens into rectum. The main function of the colon is to absorb water from the processed food residue that arrives after the nutrients have been absorbed in the small intestine. The last part of the colon is the rectum, which is a reservoir for feces. Faeces are stored here until a bowel movement occurs. The patients of ulcerative colitis have swelling along with ulcers located in their colon and rectum. Broadly speaking ulcerative colitis is included under an umbrella term called as inflammatory bowel disease (IBD). IBD is a term referring to the diseases that cause chronic inflammatory condition of digestive tract. Another condition included under this category is Crohn’s disease (give link to related conditions.htm). Crohn's disease can cause inflammation similar to ulcerative colitis anywhere in the digestive tract from the mouth to the rectum, but more commonly it attacks the small intestine in contrast to ulcerative colitis, which attacks mainly the large intestine. Ulcerative colitis: Its types: The inflammation related to ulcerative colitis usually occurs in the rectum and lower part of the colon, but it may affect the entire colon. Ulcerative colitis rarely affects the small intestine except for the lower section, called the ileum. Depending upon which portion of intestine is most affected by UC, it is put under various types as follows. Inflammation of Entire colon =Pan-colitis (pan =entire, colitis=inflammation of colon) Rectum= Proctitis Sigmoid colon (S shaped portion of colon located just above the rectum) = Sigmoiditis Beyond sigmoid colon= Left-sided colitis Pathology: Inside the large intestine, the inflammation of the inner lining (mucosa) causes death of the colon lining cells and this results in sores or ulcers. Also the inflammation makes the colon to empty frequently resulting in diarrhea. As the lining of the colon is destroyed, ulcers form releasing mucus, pus and blood. Nature of the disease: Ulcerative colitis is a chronic disease and is notorious for its waxing and waning nature. Usually the patients of ulcerative colitis have alternating periods of relative health where the patient is symptom-free or experiences very mild symptoms (remissions) alternating with periods of active disease (relapse or flare). Fortunately, as treatment has improved, the proportion of people with continued symptoms appears to have diminished significantly. How common is the condition: Ulcerative colitis is a global condition affecting people world over. It is estimated that in Unites states alone there are about one million people who suffer from some form of IBD. About half of the people with IBD have ulcerative colitis; about half have Crohn's disease. Ulcerative colitis affects people of all ages, but at large it is the disease of young adults. Most cases of UC are diagnosed in people between the ages 15 to 40 years. However, children as small as few months old and older people sometimes develop the disease. The incidence of Ulcerative colitis has risen with the tide of civilization. Moreover this is a disease of young people having grievous impact on their education and career. Ulcerative colitis does not show any gender preference and affect males and females equally. It appears to run in families. Studies also consistently conclude that ulcerative colitis occurs more often within the Jewish population.

Crohn’s disease The disease resembling most as per the symptoms, pathology, and nature to Ulcerative colitis is Crohn’s disease. Both these conditions are together called as inflammatory bowel disorders. In spite of their close resemblance, they do share some important differentiating points.   Crohn's disease (CD) is an inflammatory process of digestive system that can affect any portion of the digestive tract from mouth to anus. However, it is most commonly seen (roughly half of all cases) in the last part of the small intestine called the terminal ileum and cecum.   Crohn’s disease causes inflammation, deep ulcers and scarring in the wall of the intestine and often occurs in patches.   The main symptoms of Crohn’s disease are pain in the abdomen, urgent diarrhea, general tiredness and loss of weight. Rarely is there obvious bloody diarrhea. Nausea and vomiting may be associated with this condition. Crohn’s is sometimes associated with other inflammatory conditions affecting the joints, skin and eyes. The pain of CD is often in the lower right area of the abdomen. This is where the terminal ileum is located. CD frequently results in the development of fistulas, which are abnormal connections between loops of intestine. These may even involve other organs such as the urinary bladder or open onto the skin. If the fistulous tract appears between the intestine and the bladder, stool is allowed to pass into the urine. CD inflammation also frequently results in the formation of scar tissue with narrowed segments known as strictures. These strictures frequently cause acute crisis with bowel obstructions the symptoms of which will depend on the severity. Hemorrhoid-like skin tags and anal fissures may also develop. Crohn’s disease is a chronic condition and the severity of the symptoms fluctuates unpredictably over time. Patients are likely to experience flare-ups in between intervals of remission or reduced symptoms.   Ulcerative colitis Vs Crohn’s disease:     Ulcerative colitis Crohn’s Diseases Onset Onset of ulcerative colitis may be sudden or insidious. Onset of Crohn’s disease is usually insidious. Location(1) Ulcerative colitis affects large intestine only. Crohn’s disease can affect small intestine as well as large intestine. Location (2) Ulcerative colitis usually does affect rectum. Crohn’s disease usually doesn’t affect rectum, but frequently affects anus instead. Pathology Ulcerative colitis causes inflammation or swelling of top layer of inner lining of colon. Crohn’s disease causes inflammation of entire thickness of lining of intestine or it is much more deeper than ulcerative colitis. Incidence Ulcerative colitis is more common in non-smokers. Crohn’s diseases is more common in smokers Symptoms Ulcerative colitis is almost always associated with bloody diarrhea. Though diarrhea is main feature of Crohn’s disease, it is usually not bloody. Complications The common complication of ulcerative colitis is toxic megacolon. The common complications of Crohn’s disease include fistulas and strictures with incidental bowel obstruction. Irritable bowel syndrome (IBS) IBS, sometimes known as spastic colon, is a disorder characterized by dysfunction of motility and sensation in the bowel. Muscles in the bowel normally contract a few times a day, moving feces along and ultimately resulting in a bowel movement. It is believed that in a person with IBS, these muscles are exceptionally sensitive to stimuli, or triggers such as stress, dietary changes, and activity). While these triggers would not normally affect others, they can provoke a strong response in a person with IBS. A person who does not have IBS may have no trouble eating a salad, or drinking coffee, but a person with IBS may exhibit symptoms such as pain, bloating, and diarrhea. Studies indicate IBS is much more common than Ulcerative colitis or Crohn’s diseases.   Symptoms: Typically, people with IBS will have crampy abdominal pain along with gradual changes in their bowel pattern, often alternating between diarrhea and constipation. A hard stool followed by one or more loose stools per day or a series of hurried soft bowel movements following breakfast is common.  Stool is often hard and is passed in small pellets with straining, or can be very loose and passed with a sense of urgency. Evacuation often feels incomplete. Abdominal pain is usually on the lower left side of the abdomen but it can be present in any area. Passing gas or visiting the bathroom may temporarily relieve this cramp-like discomfort. Mucus may be present in the stool. There may be a sensation of bloating or even visible swelling of the abdomen. Some may even experience nausea and vomiting.   Diagnosing irritable bowel syndrome The diagnosis of IBS is made on the basis of symptoms and by ruling out other disorders through a thorough health history, physical examination, and some laboratory tests. An endoscopy or an x-ray may be performed. The typical symptoms of irritable bowel syndrome include abdominal pain is relieved by a bowel movement, abdominal pain associated with a change in the frequency of bowel movements, abdominal pain is associated with a change in the consistency of the stool.   Irritable bowel syndrome Vs ulcerative colitis: 1. The most crucial point is that no significant abnormalities like inflammation or ulceration are seen upon examination of the colon in patients with irritable bowel syndrome. But those with ulcerative colitis have inflammation in the colon lining that can be seen by a doctor when the colon is examined. 2.  In patients with ulcerative colitis this inflammation may lead to symptoms of diarrhea, but not usually constipation, and not always with abdominal pain. While alternating diarrhea and constipation is hallmark of irritable bowel syndrome. Another way that ulcerative colitis can be distinguished from IBS is that people with ulcerative colitis may have rectal bleeding, a symptom missing from IBS.