Most people with ulcerative colitis have mild to moderate disease. Its management depends on how active the disease is.
Mild ulcerative colitis means that the activity of the disease is typically mild and can come and go. Many patients who receive treatment shortly after they are diagnosed will see significant improvement.
While there is no cure, many patients are able to control the symptoms of the disease with continued use of prescribed medications.
Causes
The exact cause of ulcerative colitis is unknown. Experts think that a variety of factors are involved in developing ulcerative colitis, including:
An abnormal or overactive immune systemThe microbiomeGeneticsEnvironmental factors
Ulcerative colitis is considered a progressive disease. Most people are initially diagnosed with mild ulcerative colitis, which may progress into more moderate or severe forms if the symptoms are not adequately controlled.
Symptoms
Patients with mild ulcerative colitis may experience a variety of symptoms during flare-ups. These symptoms may include:
DiarrheaMild abdominal cramps and painNo bleeding or small amounts of bleeding with stool
Mild ulcerative colitis can mean less severe inflammation or a lesser extent of disease. For patients, it means experiencing less intense symptoms than more severe cases of ulcerative colitis. For example, mild ulcerative colitis may indicate fewer than four bowel movements per day and only sometimes passing blood with stool, rather than most of the time.
Additionally, generalized symptoms such as fatigue, fever, nausea, or vomiting may be experienced, depending on where the inflammation has spread and its severity. The further the inflammation is spread in the intestine, the more symptoms beyond gastrointestinal symptoms may appear.
People with mild ulcerative colitis may also experience remission, or periods of time where they experience no symptoms and discomfort as well. Periods of remission may last weeks to months to years. However, ulcerative colitis is not curable, and symptoms will return at some point.
Diagnosis
Ulcerative colitis is diagnosed based on the symptoms, family history, blood tests, stool tests, and endoscopy of the large intestine. Mild ulcerative colitis is determined based upon Truelove and Witt’s criteria, or the Mayo Clinic score.
Based upon Truelove and Witt’s criteria, indication of mild ulcerative colitis includes:
Four or fewer bowel movements per daySometimes seeing small amounts of blood in stoolNo fever, irregular heartbeats, edema, swelling, or tenderness in the abdomenMild or no anemia
The Mayo Clinic system may also be used to grade the severity of ulcerative colitis. The scoring system is composed of four categories that are graded from 0-3 (0 indicates no active disease, while 3 indicates the most severe activity).
Mild ulcerative colitis is scored as follows:
Blood streaks seen in stool less than half the timeOne to two more stools than normalMild endoscopic findings (more fragile lining of the intestine, some irritation or redness seen in the colon, decreased blood vessels)Physician assessment of mild colitis
Treatment
The goal of treatment for mild ulcerative colitis is to reduce or eliminate symptoms (remission) and improve the quality of life of patients. Most patients with mild ulcerative colitis are at low risk for colectomy and use oral medications to manage the disease.
Medications used to manage mild ulcerative colitis include:
Aminosalicylates are the most common and effective treatment for mild ulcerative colitis. More than 90% of patients with mild ulcerative colitis are treated with aminosalicylates, a medication that helps to reduce inflammation. The treatment works by allowing damaged tissue in the colon to heal. Between 60% and 87% of patients will continue to use aminosalicylates long term to help manage the disease. Corticosteroids may be recommended for patients who are unresponsive to aminosalicylates. Only 50% of patients will be prescribed corticosteroids for mild ulcerative colitis during the course of their disease. Immunosuppressives are used by 20% of patients with mild ulcerative colitis. Generally, immunosuppressives are used in more severe flare-ups of ulcerative colitis that require hospitalization. Similar to immunosuppressives, biological therapy is less commonly used for treating mild ulcerative colitis. It is only used in about 5% to 10% of mild ulcerative colitis cases and is generally reserved for patients with moderate to severe disease.
Prognosis
While there’s no cure for mild ulcerative colitis, many patients will experience periods of remission, or the disappearance of symptoms and discomfort, for months or years at a time. Continuing your course of treatment, including medications and lifestyle changes, can increase your chances of staying in remission.
Most people diagnosed with ulcerative colitis are able to lead normal lives with a typical lifespan.
A Word From Verywell
No one wants to hear that they are diagnosed with an unpredictable and lifelong disease like ulcerative colitis. If you’ve been diagnosed with mild ulcerative colitis, you may be feeling anxious and stressed.
It’s no wonder. Symptoms of an inflammatory bowel disease may be distressing, physically and mentally. However, a variety of treatments are available that can help you manage the ups and downs of this disease.
Speak with your doctor and gastroenterologist frequently to ensure you have the best possible course of treatment to keep the inflammation down and symptoms manageable.
