Ulcerative Colitis Treatment in Katy, TX
Specialist care for ulcerative colitis, with treatment aimed at healing the colon and keeping you in remission.
Understanding Ulcerative Colitis
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD). The immune system attacks the inner lining of the colon, causing inflammation and small sores (ulcers) that can bleed. Unlike Crohn’s disease, ulcerative colitis affects only the colon and rectum. It almost always starts in the rectum and spreads upward in one continuous stretch.
Doctors describe ulcerative colitis by how far it reaches. Ulcerative proctitis affects only the rectum. Left-sided colitis reaches partway up the colon. Extensive colitis (pancolitis) affects most or all of the colon. The extent helps decide which treatments work best.
Ulcerative colitis can start at any age. It most often starts between the ages of 15 and 30, and some people are first diagnosed between 50 and 70. Like Crohn’s disease, it moves in cycles of flares and remission.
Symptoms of ulcerative colitis
- Diarrhea, often with blood or mucus
- Rectal bleeding
- An urgent need to have a bowel movement, sometimes with accidents
- A feeling that you need to go even when the bowel is empty (tenesmus)
- Cramping or pain in the lower belly, often on the left side
- Waking at night to have a bowel movement
- Fatigue, weight loss and, in more severe flares, fever
Ulcerative colitis can also affect other parts of the body, causing joint pain, skin rashes, eye inflammation, anemia and, less often, a liver disease called primary sclerosing cholangitis (PSC).
What causes ulcerative colitis?
The exact cause is not known. Ulcerative colitis develops when genetics, an overactive immune response and changes in the gut bacteria come together. Having a parent, brother or sister with IBD raises your risk. Diet and stress do not cause ulcerative colitis, but they can affect how you feel during a flare.
Flares can be triggered by stopping maintenance medicine, gut infections such as C. difficile, and NSAID pain relievers such as ibuprofen and naproxen.
Possible complications
- Severe flares with heavy bleeding, dehydration and, rarely, a dangerously swollen colon (toxic megacolon)
- Anemia from ongoing blood loss
- A higher risk of colon cancer when ulcerative colitis has affected more than the rectum for many years, which is why regular surveillance colonoscopies are recommended
- Bone thinning, especially after repeated courses of steroids
When to see a gastroenterologist
See a specialist if you have diarrhea with blood or mucus, rectal bleeding, or urgency that lasts more than a few days or keeps coming back. Never assume rectal bleeding is “just hemorrhoids.” If you already have ulcerative colitis, regular follow-up keeps the inflammation under control between flares.
Call us the same day if you have six or more bloody bowel movements a day. Go to the emergency room if you also have fever, a fast heartbeat, heavy bleeding, severe belly pain or swelling, or signs of dehydration such as dizziness or very little urine. A severe flare needs hospital treatment.
Our approach to Ulcerative Colitis
Treatment starts with an accurate picture of how far the inflammation reaches and how active it is. Our gastroenterologists then build a plan to bring the flare under control, heal the lining of the colon, and keep you in remission.
Getting the diagnosis right
- A colonoscopy with biopsies, the main test for diagnosing ulcerative colitis and measuring how far it reaches. During a flare, a shorter exam of the lower colon (flexible sigmoidoscopy) is sometimes used instead.
- Stool tests, including fecal calprotectin to measure inflammation and testing for infections such as C. difficile that can look like a flare
- Blood tests for anemia, inflammation (CRP), liver function and nutrient levels
Colonoscopies are performed by our own physicians at Zazen Surgery Center, in the same building as our clinic.
Treatment that aims to heal the colon
The goal is more than fewer symptoms. We aim for normal bowel habits with no bleeding and a healed colon lining, because healing is linked to fewer flares, fewer hospital stays and a lower risk of surgery. Depending on your disease, treatment may include:
- Mesalamine (5-ASA), the main treatment for mild to moderate ulcerative colitis. It comes as tablets and as suppositories or enemas that treat the rectum and lower colon directly. For proctitis, a mesalamine suppository is usually the first choice. When colitis reaches farther, taking tablets along with a mesalamine enema often works better than tablets alone.
- Corticosteroids, such as budesonide or prednisone, to calm a flare quickly. These are used for short periods only, not for long-term control.
- Biologic and advanced therapies for moderate to severe disease, or when other treatments have not worked. These include anti-TNF medicines, vedolizumab, ustekinumab and IL-23 inhibitors, given by infusion or injection, and oral medicines such as JAK inhibitors and S1P receptor modulators. JAK inhibitors are usually used after an anti-TNF medicine has been tried or is not a good fit, and they carry safety warnings we review with you. We help you choose the option that fits your disease, your health history and your life.
- Immunomodulators, such as azathioprine, sometimes added to an anti-TNF medicine to help it work better, or used to stay in remission after coming off steroids. They work too slowly to treat a flare on their own.
- Surgery for severe disease that does not respond to medicine, or for precancerous changes. Removing the colon and rectum takes away the diseased bowel, and many patients have a J-pouch made from the small intestine so they do not need a permanent bag. A J-pouch can have its own problems, such as inflammation of the pouch (pouchitis), and some conditions linked to ulcerative colitis, such as PSC, can continue after surgery. When surgery is needed, we work closely with colorectal surgeons.
Monitoring and staying well
- Regular checks with stool and blood tests, and a colonoscopy when needed, to confirm the colon is healing
- Surveillance colonoscopies, usually starting about 8 years after symptoms began if ulcerative colitis reaches beyond the rectum, and every year from diagnosis if you also have PSC
- Nutrition support from our registered dietitians, especially during flares or if you are low in iron
- Vaccinations and bone health checks, which matter more when you take steroids or medicines that affect the immune system
Ulcerative colitis care has changed a great deal. There are now many more treatment options than even a few years ago, and our goal is not just fewer trips to the bathroom but a colon that has truly healed.
Dr. Vivian Asamoah, MD
Board-Certified Gastroenterologist, Integrative Medicine
Key Facts
What you need to know
Everything you need to know before your appointment.
Who should consider this
Anyone with bloody diarrhea, urgency or rectal bleeding, or ulcerative colitis that is not well controlled.
Learn more
What to expect
A detailed first visit, the right tests, and a treatment plan matched to how far and how active your colitis is.
Learn more
Recovery and results
Many people feel better within weeks, while healing of the colon is checked over time.
Learn more
Why our team
Experienced gastroenterologists, on-site colonoscopy and dietitians, all coordinated in one place.
Learn moreWhat Our Patients Say
-
Dr. Asamoah is a wonderful doctor with an excellent bedside manner who cares about what you're going through and leaves no stone unturned I highly recommend.
-
From the moment of entering the Surgical Center, I felt like I was an individual and my needs were of concern. The actual procedure experience was great. Dr. Asamoah has a way of making you feel at ease. She's gathered a staff of people who do the same thing. Highly recommend.
-
I was very impressed with both doctors' expression of authentic interest in and concern with my health concerns. A rare experience.
-
Highly recommend. The office staff and Dr. Asamoah were helpful, friendly and very accommodating! We left feeling like we have answers and are hopeful.
-
First time visit. Impressed by the clean and nice environment. Friendly staff. Doctor takes her time to hear you and answer any questions you have. Great experience.
-
Wow!!! Absolutely amazed by the facility and doctor! Dr. Vivian Asamoah is extremely educational, professional, and so sweet! I went in feeling extremely anxious because of my health issues, and she put me at ease by explaining every detail! Xiomara, her MA, was so helpful and thorough. Honestly, she is by far one of the best doctors I've seen. God bless this office and everyone in it! I most definitely recommend her!
-
I went in to check on issues I was having with my colon. I was in a panic and was not feeling my best. Dr. Asamoah was kind and very understanding, with great patient-relationship skills. She is genuine and truly professional. Her staff is great and wonderful. I will recommend my family and friends.
-
Had a great experience. The doctors are very understanding and comforting. They listen to all of your needs. Loved their music. Very relaxing.
Individual results vary.
Ready to talk with a specialist about your ulcerative colitis care?
Schedule a consultation with our team. We are here to help you find lasting relief.
Expert GI. Whole-person care. All under one roof.Common questions about Ulcerative Colitis
Early signs often include diarrhea with blood or mucus, rectal bleeding, an urgent need to have a bowel movement, and cramping in the lower belly. Some people also have fatigue, weight loss or waking at night to use the bathroom.
Medicine cannot cure ulcerative colitis, but it can control the inflammation and keep many people in remission for years. Surgery to remove the colon and rectum takes away the diseased bowel, but it is usually reserved for severe cases or precancerous changes. Some people still have related problems afterward, such as inflammation of the J-pouch (pouchitis).
Both are types of inflammatory bowel disease. Ulcerative colitis affects only the colon and rectum, in one continuous stretch, and mainly the inner lining. Crohn's disease can affect any part of the digestive tract, often in patches, and can involve the full thickness of the bowel wall.
IBS causes pain and changes in bowel habits but does not damage the bowel or cause bleeding. Ulcerative colitis causes real inflammation and ulcers that can be seen on colonoscopy, and often causes bleeding. A gastroenterologist can tell them apart with stool tests and, if needed, a colonoscopy.
Common triggers include stopping or missing maintenance medicine, gut infections such as C. difficile, and NSAID pain relievers such as ibuprofen and naproxen. Stress and certain foods do not cause ulcerative colitis but can make symptoms worse for some people.
Diagnosis combines your symptoms with stool and blood tests and a colonoscopy with biopsies. The colonoscopy confirms the diagnosis, shows how far the inflammation reaches, and rules out other causes.
No diet cures ulcerative colitis or replaces medicine. During a flare, some people feel better eating smaller meals and fewer high-fiber or greasy foods. A registered dietitian can help you eat well, avoid unnecessary restrictions and correct low iron.
The risk is higher when ulcerative colitis has affected more than the rectum for many years. Regular surveillance colonoscopies, usually starting about 8 years after symptoms began for colitis that reaches beyond the rectum, or every year from diagnosis if you also have PSC, find and remove precancerous changes early. Colitis limited to the rectum does not raise the risk.
Usually yes. Maintenance treatment keeps the inflammation quiet and greatly lowers the chance of a flare. Stopping medicine is one of the most common reasons people relapse, so talk to your gastroenterologist before making any change.
Yes. Most people with ulcerative colitis work, travel, exercise and raise families. The key is finding a treatment that controls the inflammation and keeping up with follow-up care.
Houston Gastro Institute diagnoses and treats ulcerative colitis and other inflammatory bowel diseases at our clinic on Kingsland Boulevard in Katy, TX. Patients come to us from across west Houston, including Cinco Ranch, Fulshear, Richmond, Brookshire, Sugar Land and Cypress. Colonoscopies are performed at Zazen Surgery Center in the same building.