Ulcerative Colitis

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Ulcerative Colitis

Topic Overview

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Ulcerative colitis and Crohn's disease are the most common types of inflammatory bowel disease. Ulcerative colitis affects only the colon and rectum. Crohn’s can affect any part of the digestive tract. To learn more about Crohn’s disease, see the topic Crohn’s Disease.

What is ulcerative colitis?

Ulcerative colitis is a disease that causes inflammation and sores (ulcers) in the lining of the large intestine (colon). It usually affects the lower section (sigmoid colon) and the rectum. But it can affect the entire colon. In general, the more of the colon that’s affected, the worse the symptoms will be.

Ulcerative colitis can affect people of any age. But most people who have it are diagnosed before the age of 30.

What causes ulcerative colitis?

Experts are not sure what causes ulcerative colitis. They think it might be caused by the immune system overreacting to normal bacteria in the digestive tract. Or other kinds of bacteria and viruses may cause the disease.

You are more likely to get ulcerative colitis if other people in your family have it.

What are the symptoms?

The main symptoms are:

  • Belly pain or cramps.
  • Diarrhea.
  • Bleeding from the rectum.

Some people also may have a fever, may not feel hungry, and may lose weight. In severe cases, people may have diarrhea 10 to 20 times a day.

Ulcerative colitis can also cause other problems, such as joint pain, eye problems, or liver disease.

In most people, the symptoms come and go. Some people go for months or years without symptoms (remission). Then they will have a flare-up. About 5 to 10 out of 100 people with ulcerative colitis have symptoms all the time.1

Ulcerative colitis sometimes leads to more serious problems. It can cause scarring of the bile duct. This can lead to liver damage. In rare cases, severe disease causes the colon to swell to many times its normal size (toxic megacolon). This can be deadly and needs emergency treatment.

People who have ulcerative colitis for 8 years or longer have a greater chance of getting colon cancer. The longer you have had ulcerative colitis, the greater your risk.2 Talk to your doctor about your need for cancer screening. Screening tests help find cancer early, when it is easier to treat.3

How is ulcerative colitis diagnosed?

To diagnose ulcerative colitis, doctors ask about the symptoms, do a physical examination, and do a number of tests. Testing can help the doctor rule out other problems that can cause similar symptoms, such as Crohn’s disease, irritable bowel syndrome, or diverticulitis.

Tests that may be done include:

  • A colonoscopy. In this test, a doctor uses a thin, lighted tool to look at the inside of your entire colon. At the same time, the doctor may take a sample (biopsy) of the lining of the colon.
  • Blood tests, which are done to look for infection or inflammation.
  • Stool sample testing to look for blood, infection, and white blood cells.

How is it treated?

Ulcerative colitis affects everyone differently. Your doctor will help you find treatments that reduce your symptoms and help you avoid new flare-ups.

If your symptoms are mild, you may only need to use over-the-counter medicines for diarrhea (such as Imodium). Talk to your doctor before you take these medicines.

Medicines used to treat ulcerative colitis include:

  • Aminosalicylates. These can be used to reduce or stop symptoms (sometimes at the same time as steroid medicines). After your symptoms are under control, you may take these medicines to help prevent flare-ups.
  • Steroid medicines. These can help reduce or stop symptoms. They are only used for short periods because they can cause side effects, such as bone thinning (osteoporosis).
  • Medicines that control the immune system (immunomodulators). You may need these if your disease is severe and aminosalicylates don't keep it from flaring up.

Some people find that certain foods make their symptoms worse. If this happens to you, it makes sense to not eat those foods. But be sure to eat a healthy, varied diet to keep your weight up and to stay strong.

If you have severe symptoms and medicines don't help, you may need surgery to remove part or all of your colon. Removing the entire colon cures ulcerative colitis. It also prevents colon cancer.

How will ulcerative colitis affect your life?

Ulcerative colitis can be hard to live with. During a flare-up it may seem like you are always running to the bathroom. This can be embarrassing and can take a toll on how you feel about yourself. Not knowing when the disease will strike next can be stressful.

If you are having a hard time, seek support from family, friends, or a counsellor. Or look for an ulcerative colitis support group. It can be a big help to talk to others who are coping with this disease.

Frequently Asked Questions

Learning about ulcerative colitis:

Being diagnosed:

Getting treatment:

Ongoing concerns:

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Decision Points focus on key medical care decisions that are important to many health problems. Decision Points focus on key medical care decisions that are important to many health problems.
  Ulcerative Colitis: Should I Have Surgery?

Actionsets help people take an active role in managing a health condition. Actionsets are designed to help people take an active role in managing a health condition.
  Bowel Disease: Caring for Your Ostomy
  Bowel Disease: Changing Your Diet

Cause

The cause of ulcerative colitis is unknown. It may result from an abnormal response by the body's immune system to normal intestinal bacteria. Disease-causing bacteria and viruses also may play a role in causing the condition.

Ulcerative colitis can run in families—some people may have a genetic tendency to have it.

Symptoms

The symptoms of ulcerative colitis may include:

  • Diarrhea or rectal urgency. Some people may have diarrhea 10 to 20 times a day. The urge to go to the bathroom may wake you up at night.
  • Rectal bleeding. Ulcerative colitis usually causes bloody diarrhea and mucus. You also may have rectal pain and an urgent need to empty your bowels.
  • Abdominal (belly) pain, often described as cramping. Your abdomen may be sore when touched.
  • Constipation. This symptom may develop depending on what part of the colon is affected. Constipation is much less common than diarrhea.
  • Loss of appetite.
  • Fever. In severe cases, fever or other symptoms that affect the entire body may develop.
  • Weight loss. Ongoing (chronic) symptoms, such as diarrhea, can lead to weight loss.
  • Too few red blood cells (anemia). Some people develop anemia because of low iron levels caused by bloody stools or intestinal inflammation.

You also may have symptoms and complications outside the digestive tract, such as joint pain, eye problems, skin rash, or liver disease.

Other conditions with symptoms similar to ulcerative colitis include Crohn's disease, diverticulitis, irritable bowel syndrome (IBS), and colon cancer.

What Happens

Ulcerative colitis may be mild, moderate, or severe. It may be described as dependent on corticosteroids, unresponsive to steroids, active, or not active (in remission).

Ulcerative colitis also may be defined by the part of the large intestine affected: the rectum (proctitis), the left side of the colon (left-sided colitis), or the entire colon (pancolitis).

Most people with ulcerative colitis have periods of remission that may last up to several years. These periods are interrupted by occasional flare-ups of moderate symptoms. About 5 to 10 out of 100 people who have ulcerative colitis have symptoms all the time.1

Children may have the same symptoms as adults. Also, children with ulcerative colitis may grow more slowly than normal and go through puberty later than expected.

Complications and long-term effects

  • Inflammation and scarring of the bile ducts (primary sclerosing cholangitis) may occur. A bile duct is a passage that carries fluid produced in the liver to the small intestine.
  • Severe inflammation and ulceration sometimes irritate muscles in the colon, causing colon walls to stretch. The colon may swell to many times its normal size, a condition known as toxic megacolon. This is an emergency that requires immediate treatment, but it is rare.
  • Narrowed areas of the intestine (strictures) may occur in ulcerative colitis, causing difficulty in passing stools.
  • Your risk of cancer of the colon and rectum is higher than average if you have had ulcerative colitis for 8 years or longer. With regular screening, some cancers can be detected early and treated successfully.
  • Ulcerative colitis can cause rare complications such as scarring of the pancreas and inflammation of the membrane surrounding the heart (pericarditis).

Some people who have ulcerative colitis also have irritable bowel syndrome (IBS), which is not as serious as ulcerative colitis. IBS causes abdominal pain along with diarrhea or constipation.

Most women with ulcerative colitis can have a normal pregnancy and deliver a healthy baby. Symptoms may become worse during the first 3 months of pregnancy. Some medicines to treat the disease can be used during pregnancy.

What Increases Your Risk

You have an increased risk of ulcerative colitis if you:

  • Have a family history of ulcerative colitis. Your risk increases if an immediate family member such as a parent, brother, or sister has the disease.
  • Are of Ashkenazi Jewish ancestry. For more information on genetic diseases in this group, see the topic Ashkenazi Jewish Genetic Panel (AJGP).

When To Call a Doctor

Call a doctor immediately if you have been diagnosed with ulcerative colitis and you have any of the following:

  • Fever over 38.5°C (101°F) or shaking chills
  • Light-headedness, passing out, or rapid heart rate
  • Stools that are almost always bloody
  • Severe dehydration
  • Severe belly pain with or without bloating
  • Pus draining from the area around the anus or pain and swelling in the anal area
  • Repeated vomiting
  • Not passing any stools or gas

If you have any of these symptoms and you have been diagnosed with ulcerative colitis, your disease may have become significantly worse. Some of these symptoms also may be signs of toxic megacolon, a condition in which the colon swells to many times its normal size. Toxic megacolon requires emergency treatment. Untreated toxic megacolon can cause the colon to leak or rupture, which can be fatal.

People who have ulcerative colitis usually know their normal pattern of symptoms. Call your doctor if there is a change in your usual symptoms or if:

  • Your symptoms become significantly worse than usual.
  • You have persistent diarrhea for more than 2 weeks.
  • You have lost weight.

Watchful Waiting

Watchful waiting is not appropriate when you have any of the above symptoms. If your symptoms are caused by ulcerative colitis, delaying the diagnosis and treatment may make the disease worse and increase your risk of complications.

Even when the disease is in remission, your doctor will want to see you regularly to check for complications, some of which can be hard to detect. It is always appropriate to call your doctor's office for advice.

Who To See

Your family doctor or general practitioner can diagnose ulcerative colitis. If you need specialized care, you may be referred to an internist or a gastroenterologist.

To be evaluated for surgery, you may be referred to a:

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Examinations and Tests

Ulcerative colitis can be relatively easy to diagnose because it normally affects only the colon and rectum and usually causes an obvious change in daily bowel habits, such as frequent stools containing blood or mucus. Your doctor will conduct a medical history and physical examination before doing other tests.

The colon and rectum can be examined with flexible sigmoidoscopy or colonoscopy, tests in which a doctor examines the inside of the large intestine using a small, lighted scope. In general, colonoscopy is the preferred test because it can be used to examine the entire colon. But flexible sigmoidoscopy may be all that is needed to diagnose ulcerative colitis. Both procedures can be used to take a sample (biopsy) of intestinal tissue. The diagnosis of ulcerative colitis is made by ruling out other causes of diarrhea and assessing the results of these tests.

Other examinations and tests that may be used to evaluate ulcerative colitis include:

  • Abdominal X-ray, which provides a picture of structures and organs in the abdomen.
  • Barium enema, a test that allows the doctor to examine the large intestine (colon).
  • Computed tomography (CT) scan, which uses X-rays to produce detailed pictures of structures inside the body.
  • Magnetic resonance imaging (MRI), which uses a magnetic field and pulses of radio wave energy to provide pictures of organs and structures inside the body.
  • Stool analysis (including a test for blood in the stool), to look for blood, signs of bacterial infection, parasites, or the presence of white blood cells.
  • Standard blood and urine tests, to check for anemia, inflammation, or malnutrition. Depending on the symptoms, an erythrocyte sedimentation rate (ESR, or sed rate) or a C-reactive protein (CRP) blood test may be done to look for infection or inflammation.
  • Biopsy of a sample of tissue from the lining of the intestine. Biopsies are collected during sigmoidoscopy or colonoscopy to confirm the diagnosis of ulcerative colitis. A biopsy also may be done to find out whether a tumour is present. Multiple biopsies are often done to screen for cancer in people who have had ulcerative colitis for 8 years or more. Bowel biopsies are painless (other than the potential discomfort of the scope procedure) and remove only a tiny piece of tissue.

Some people have symptoms of inflammatory bowel disease and neither Crohn's disease nor ulcerative colitis can be diagnosed. These people have a form of inflammatory bowel disease called indeterminate colitis, which doctors believe is a combination of Crohn's disease and ulcerative colitis.

Treatment Overview

Treatment for ulcerative colitis depends mainly on the severity of the disease and usually includes medicines to control symptoms, such as diarrhea, and changes in diet. A few people have symptoms that are persistent and severe, in some cases requiring treatment with additional medicines or surgery.

For more information about making good food choices, see:

Click here to view an Actionset. Bowel Disease: Changing Your Diet.

The goals of treatment include:

  • Relieving symptoms and ending sudden (acute) attacks as quickly as possible.
  • Treating complications, such as anemia or infection. Treatment may include taking nutritional supplements to restore normal growth and sexual development in children and teens.
  • Preventing or delaying new attacks.

Initial treatment

If you don't have any symptoms of ulcerative colitis or if your disease is not active (in remission), you may not need treatment. If you do have symptoms, they usually can be managed with medicines to put the disease in remission. It often is easier to keep the disease in remission than to treat a flare-up.

Mild symptoms may respond to antidiarrheal medicines and changes in your diet. Sometimes you may need to use enemas or suppositories. Talk with your doctor before taking antidiarrheals. Prescription medicines may be used to treat mild symptoms and keep the disease in remission. Usually, corticosteroids (such as hydrocortisone or prednisone) are given for a few weeks to control active disease. Aminosalicylates (such as sulfasalazine or mesalazine) will often also be used to reduce or stop symptoms, sometimes at the same time as corticosteroids.

When your symptoms are under control, you may continue to take aminosalicylates to keep the disease in remission. Aminosalicylates relieve inflammation in the intestines.

Moderate to severe symptoms usually require corticosteroids to control inflammation. The required dose of steroids may be higher than that needed to treat mild colitis. When inflammation goes away, you will take aminosalicylates to keep the condition in remission.

Immunomodulator medicines, such as azathioprine (AZA) or mercaptopurine, also may be needed for severe cases that cannot be controlled with aminosalicylates alone. These medicines suppress the body's immune system to prevent inflammation. Immunomodulators also may be needed to avoid long-term use of steroids, which can cause side effects such as increased risk of infection and osteoporosis.

For severe ulcerative colitis, when corticosteroids don't work, your doctor may have you try biologics (such as infliximab). Biologics may work to put you in remission when other medicines don't. They have also been shown to help heal the lining of the intestine.

Ongoing treatment

The goal of ongoing treatment is to keep ulcerative colitis from causing symptoms (keep it in remission). Most people take aminosalicylates (such as sulfasalazine or mesalazine) to prevent symptoms from recurring. Aminosalicylates relieve inflammation in the intestines. If you do have flare-ups, you may be given corticosteroids (such as hydrocortisone or prednisone) to control the inflammation.

Usually, steroids are given only long enough to control inflammation. If your condition is so severe that aminosalicylates alone cannot keep you in remission and you would need long-term use of steroids, you may take immunomodulator medicines (such as azathioprine [AZA], mercaptopurine, or cyclosporine). These strong medicines suppress the immune system to prevent inflammation.

If these medicines don't work, your doctor may have you try biologics (such as infliximab). Biologics also block the inflammatory response in your body and help reduce the inflammation in your colon.

Your doctor will want to see you for a follow-up visit about every 6 months while your condition is stable and more frequently if you are having problems. If you are taking medicines, you may have laboratory tests every 2 to 3 months. Many people who have ulcerative colitis are so familiar with the course of their condition that they can handle minor flare-ups on their own. In some cases, you may be able to consult with your doctor on the phone for minor problems.

Treatment if the condition gets worse

You may have to receive treatment in the hospital if you have severe, persistent ulcerative colitis with symptoms outside the digestive tract, such as fever or anemia. Treatment includes replacing fluids and electrolytes lost because of severe diarrhea.

Your doctor may increase your dose of corticosteroids (such as hydrocortisone or prednisone) to control active disease or may increase your immunomodulator medicines (such as azathioprine [AZA], mercaptopurine, or cyclosporine) or biologics (such as infliximab) to suppress your immune system. But steroids are usually not used as long-term therapy.

Surgery may be necessary if your symptoms do not improve with medicines or you have complications such as bleeding or perforation of the intestine. Removal of the large intestine (colon) cures ulcerative colitis. Some people with severe ulcerative colitis need urgent surgery to remove their colon. Several types of surgery can be done. For more information, see the Surgery section of this topic.

Some people who have precancerous changes in their colon may decide to have surgery to prevent cancer even if they have no symptoms. In some cases, people decide to have their colon removed to improve their quality of life and to eliminate the risk of colon cancer.

Click here to view a Decision Point. Ulcerative Colitis: Should I Have Surgery?

Prevention

You cannot prevent ulcerative colitis because the cause is unknown. But you can take steps to reduce the severity of the disease.

  • Medicines taken regularly may reduce acute attacks and keep the disease in remission.
  • Most experts recommend acetaminophen (Tylenol) for pain relief rather than non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. NSAIDs have been linked to flare-ups of inflammatory bowel disease (IBD).

Antibiotics may make ulcerative colitis symptoms worse and should only be used when necessary.

Home Treatment

If ulcerative colitis does not cause symptoms, no treatment is needed. If you have only mild symptoms, antidiarrheal medicines and changes in diet and nutrition may help. For disease in the rectum alone, you can try topical medicines (suppository, enema, or foam). Ask your doctor about these products. For more information about making good food choices, see:

Click here to view an Actionset. Bowel Disease: Changing Your Diet.

In general, doctors recommend that you do not use non-steroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen). These medicines may cause flare-ups of ulcerative colitis. But some people may be more likely to have flare-ups from NSAIDs than others. Talk to your doctor about whether to avoid these medicines.

If you have had or are planning to have surgery that will create an opening from the intestines to the outside of the body through which stool passes (ostomy), you may feel self-conscious or embarrassed. After a period of adjustment, most people are able to resume all of their usual activities. In fact, you may feel better than before surgery because you may no longer have painful symptoms. Support groups are available for people with ostomies.

Click here to view an Actionset. Bowel Disease: Caring for Your Ostomy

Children with ulcerative colitis may feel self-conscious if they do not grow as fast as other children their age. Encourage your child to take medicine as prescribed. Offer your help with the treatment so that your child can feel better, start growing again, and lead a more normal life. Children tend to have a harder time managing ulcerative colitis than adults. So your support is very important.

Medications

Medicines usually are the treatment of choice for ulcerative colitis. They control or prevent inflammation in the intestines and help:

  • Relieve symptoms.
  • Promote healing of damaged tissues.
  • Put the disease into remission and keep it from flaring up again.
  • Postpone or prevent the need for surgery.

Medication Choices

The choice of medicine usually depends on the severity of the disease, the part of the colon affected, and whether complications are present.

  • Treatment of mild to moderate ulcerative colitis often begins with aminosalicylates (such as sulfasalazine or mesalazine). Aminosalicylates relieve inflammation in the intestines and help the disease go into remission. They may also keep the disease from becoming active again.
  • Corticosteroids may be added if symptoms continue. Corticosteroids relieve inflammation in the intestines.
  • For severe cases, stronger treatment with medicines that suppress the immune system (such as azathioprine [AZA], mercaptopurine, or cyclosporine), biologics (such as infliximab), and intravenous (IV) corticosteroids may be needed.

If you are pregnant or planning to become pregnant, talk to your doctor about which medicines might be okay to use for ulcerative colitis. Sometimes severe ulcerative colitis can harm your baby more than the medicines you are taking to keep it under control. Some medicines, though, should never be taken when you are pregnant. Your doctor can tell you which medicines are okay for you while you are pregnant or breast-feeding.

What To Think About

Aminosalicylates are the most common medicines used to treat ulcerative colitis. Most of the time, these medicines are all a person needs to keep the disease in remission (a period of time with no symptoms). When aminosalicylates do not work, corticosteroids are most often the next medicine tried. Corticosteroids will only be used long enough to stop the inflammation in your colon. After the inflammation goes down, aminosalicylates will most likely be used to keep you in remission.

If aminosalicylates are not strong enough to keep you in remission, or if corticosteroids don't work, your doctor may have you try different medicines. These medicines include immunomodulators, cyclosporine, and infliximab. All of these medicines control the immune response in your body and will reduce the inflammation in your intestine. The inflammation is what causes the symptoms of ulcerative colitis.

Surgery

Ulcerative colitis affects only the large intestine. So surgery that removes the entire large intestine can cure the disease. Some people who have ulcerative colitis in the entire colon (pancolitis) eventually need surgery to remove the colon.

People may need surgery for ulcerative colitis in several situations, such as when other therapy fails to manage symptoms, when holes develop in the large intestine, or if dysplasia is found during colonoscopy or biopsy.

Click here to view a Decision Point. Ulcerative Colitis: Should I Have Surgery?

Surgery Choices

Removal of the colon to cure ulcerative colitis involves one of these surgeries:

  • In ileoanal anastomosis, the surgeon removes some or all of the large intestine (colon) and the diseased lining of the rectum. Then the end of the small intestine (the ileum) is connected to the anal canal. The anal sphincters are saved, and this allows you to have bowel movements without an ostomy.
  • In proctocolectomy and ileostomy, the large intestine and rectum are removed, leaving the lower end of the small intestine (the ileum). The surgeon sews the anus closed and makes a small opening called a stoma in the skin of the lower abdomen. The ileum is connected to the stoma, creating an opening to the outside of the body. Stool empties into a small plastic pouch called an ostomy bag that is applied to the skin around the stoma.

What To Think About

Ileoanal anastomosis is performed most often. Proctocolectomy with ileostomy is preferred for people who cannot tolerate anesthesia for a long period of time because of illness or age.

Both children and adults may have ileoanal anastomosis, which may be done in stages to reduce the risk of complications. A temporary ileostomy is created first, with the ileum pouch completed 3 to 6 months later. Surgery can improve a child's well-being and quality of life and restore normal growth and sexual development.

In the past, many people who had surgery for IBD had an ileostomy and wore an ostomy bag outside the abdomen. Newer surgeries like ileoanal anastomosis can eliminate the need for an ostomy bag with fairly good results when they are done by a trained surgeon. Traditional ostomy surgery is easier and may have fewer risks and complications than the newer procedures, but some people may be less satisfied with the results.

People with ulcerative colitis may choose to have their colon removed because their symptoms cause a poor quality of life. They also may want the surgery to prevent the possibility of colon cancer.

In most cases, surgery can be scheduled at your convenience. Emergency surgery usually is not needed unless an acute attack causes toxic megacolon, severe uncontrolled bleeding, or a spontaneous rupture in the intestine. The risk of complications after surgery can be high if surgery is done during a severe or rapidly worsening attack or if emergency surgery is needed. If toxic megacolon occurs, surgery may be the only option to save a person's life.

Other Treatment

Even though there is little scientific proof that it works, many people with ulcerative colitis consider nontraditional or complementary medicine in addition to prescription medicines. They may turn to these alternatives because there is no complete cure other than removal of the colon. Other reasons for seeking complementary medicine include:

  • Coping with the difficult side effects from standard medicines.
  • Dealing with the emotional strain caused by chronic disease.
  • Dealing with the negative impact that severe disease has on daily life.

Other Treatment Choices

Several studies have shown that the nicotine patch may help treat active ulcerative colitis. It is not yet known how long the benefits of the nicotine patch last or if the patch can help prevent flare-ups of ulcerative colitis. If the patch works, it most likely benefits people whose symptoms began or became worse after quitting smoking. But due to the addictive power and other harmful effects of nicotine, most doctors still prefer to use traditional medicines to treat ulcerative colitis before trying the nicotine patch.

Complementary medicine

The various complementary therapies include:

  • Special diets or nutritional supplements, such as probiotics.
  • Fatty acids found in oily fish, such as salmon and tuna.
  • Vitamin supplements, such as vitamins D and B12.
  • Herbs, such as aloe and ginseng.
  • Massage.
  • Stimulation of the feet, hands, and ears to try to affect parts of the body (reflexology).
  • Chiropractic therapy.

Probiotics and fatty acids are the most promising complementary therapies being studied for ulcerative colitis. But there is still not much known about their value. As with any treatment, talk with your doctor before using complementary medicines or therapies.

What To Think About

You may want to seek professional counselling or social support from family, friends, or clergy. Ulcerative colitis can affect every aspect of your life.

Other Places To Get Help

Organizations

Canadian Association of Gastroenterology
1540 Cornwall Road
Suite 224
Oakville, ON  L6J 7W5
Phone: 1-888-780-0007
(905) 829-2504
Fax: (905) 829-0242
Email: general@cag-acg.org
Web Address: www.cag-acg.org
 

The Canadian Association of Gastroenterology (CAG) provides educational information and supports research about digestive health and disease.


Crohn's and Colitis Foundation of Canada (CCFC)
600-60 St. Clair Avenue East
Toronto, ON  M4T 1N5
Phone: (416) 920-5035
1-800-387-1479
Fax: (416) 929-0364
Email: ccfc@ccfc.ca
Web Address: www.ccfc.ca
 

The Crohn's and Colitis Foundation of Canada is a national not-for-profit voluntary medical research foundation. The CCFC raises funds for medical research, and provides educational and informational materials on inflammatory bowel disease (IBD) to patients, their families, health professionals, and the general public. The CCFC has many local chapters across Canada.


United Ostomy Association of Canada
P.O. Box 825-50 Charles Street East
Toronto, ON  M4Y 2N7
Phone: (416) 595-5452
1-888-969-9698
Fax: (416) 595-9924
Email: info@ostomycanada.ca
Web Address: www.ostomycanada.ca

References

Citations

  1. Su C, Lichtenstein GR (2006). Ulcerative colitis. In M Feldman et al., eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 8th ed., vol. 2, pp. 2499–2548. Philadelphia: Saunders Elsevier.
  2. American Gastroenterological Association (2010). AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology, 138(2): 738–745. Available online: http://www.gastro.org/practice/medical-position-statements.
  3. Kornbluth A, Sachar DB (2010). Ulcerative colitis practice guidelines in adults: American College of Gastroenterology, Practice Parameters Committee. American Journal of Gastroenterology, 105(3): 501–523. Available online: http://www.acg.gi.org/physicians/clinicalupdates.asp#guidelines.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Primary Medical Reviewer Andrew Swan, MD, CCFP, FCFP - Family Medicine
Specialist Medical Reviewer Arvydas D. Vanagunas, MD - Gastroenterology
Last Revised December 6, 2010

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.