Does ulcerative colitis always involve the rectum? Need your comments!

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New Member

Date Joined Mar 2009
Total Posts : 7
   Posted 8/24/2009 10:44 PM (GMT -6)   
OK, so here's my query:

I was diagnosed with UC in 1996 following a scope. For the past seven years I was in remission until a recent trip to Cuba in Feb of this year. When things started flaring up, it was accompanied by cramping (which I had never really had before) in my abdomen - things seemed worse than before. After a few rounds of the old pred, it became apparent that I was steroid dependent now and thus, I have weaned myself off and waiting for the 'next step' (remicade).

I went in for a flex scope (which only does the first part of the colon) last week so my doc could see what was going on. I was expecting the rectum to be in bad shape. However, he said that things in that area were crystal clear (to my total surpise). I am currently having 4 - 10 bowel movements a day with quite a bit of blood - so where is blood coming from? I have advised my doc of this and he is now saying that perhaps I have Crohn's instead. Perhaps I am in denial (would rather have UC of course), but has anyone else had UC without their rectum being affected? ie: the inflamed area is limited to the transverse colon (where is goes across the abdomen (which is where I am still having cramping)) Please provide your comments and similar stories.

Thank you, MD

Veteran Member

Date Joined Jun 2009
Total Posts : 2012
   Posted 8/24/2009 10:46 PM (GMT -6)   
Dr-A had something similar to this posted I think.

Personally, I don't get diarrhea til the inflammation starts moving up. What meds are you on? If you're on rectal meds, maybe that's why the rectum is fine, and you could be getting the blood and diarrhea from further up?
19yr old female diagnosed with UC (pancolitis) in 2005 at age 15
125mg Azathioprine 1xday / 1 Mesalamine enema every night /
2000mg Fish Oil 1xday / 500mg Turmeric 3xday /
450mg Boswellia 2xday / 400IU Vitamin E 1xday
Arthritis in both knees
Also: asthma, acid reflux, and Reynaud's Syndrome

Elite Member

Date Joined Feb 2004
Total Posts : 20577
   Posted 8/25/2009 1:02 AM (GMT -6)   
It often starts in the rectom but there are plenty of UCers that have only (or mostly only) their colons affected without always having rectal can also start in the colon as well and not in the rectom.


My bum is broken....there's a big crack down the middle of it! LOL :)

Elite Member

Date Joined May 2003
Total Posts : 30995
   Posted 8/25/2009 2:04 AM (GMT -6)   
It's pretty much most UCers have the rectum involved....I best not say all...but it's not a common thing for it to not.

But, if you were initially diagnosed with UC...I'll bet your rectum was involved.

One interesting article I read not too long back (but I don't have the right, I'll wing it as best I can)...With some UCers, their rectum will become "fatigued" in the way that it doesn't get inflamed anymore...just above it if that's also affected.. I think it has to do with chronic rectal inflammamation...or certain meds.

Must find the article.

You can easily get a copy of your report....

The other thing is that you don't have UC but you have CD....or you are misdiagnosed having something else. There are other bowel disease/disorders/invaders that can mimic UC.

Ask for your initial report since it's your body you're enquiring about.

The bleeding would come from above....maybe a patch that's overly fragile..

Are you not on any other meds at this time?...have you never tried any 5ASA meds such as Asacol/Pentasa/Colazal?


*Heather* Status: ...Asacol 3 twice daily; Salofalk enemas every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!

Veteran Member

Date Joined Sep 2007
Total Posts : 955
   Posted 8/25/2009 1:22 PM (GMT -6)   
my last severe flare had no inflammation at all in the rectum. it was all left sided and transverse colon.
rectum was great!
although it didnt fee like it!!!!!!
steph - 33 - female - gold coast australia - UC since 2000
im in remission ~ wOOhOO !  no symptoms for last 2 weeks!
waiting for blood test to see if i can start imuran
just finished 3 months of prednisolone (worked) -tapered with no issues -left with moonface + fat! o.0
mesalazine granules 3g x1 a day (much nicer than a million tablets a day)
tumeric capsules, vitamin d3, enteric coated fish oil, xango juice 30ml x3 a day
pre-conception vitamins and minerals (cuz we trying to make a baby)
i still eat what i want, when i want, if i feel like eating at all ... diet doesn't affect my UC.

Regular Member

Date Joined Jul 2009
Total Posts : 321
   Posted 8/25/2009 2:55 PM (GMT -6)   

My scopes have never shown any inflammation in the rectum. I have always had issues a lot further up. I have some blood and mucus in my stools when in a flare. I think no matter where inflammation is sucks. smhair


UC since 2002- remission for 6 years
recent flare 06/09
Currently on Colazal, multivitamin, probiotics, fish oil
just tapered off prednisone

Regular Member

Date Joined Apr 2006
Total Posts : 229
   Posted 8/25/2009 6:06 PM (GMT -6)   
I have had inflammation only in the rectum at a scope and not in the rectum at all but much further up and no inflammation at all. Generally but not always if the rectum only is involved the blood is a brighter red, "fresher" looking. You might want to consider a parasite test even though Cuba has pretty good sanitation you might have picked something up.

Veteran Member

Date Joined Feb 2005
Total Posts : 2103
   Posted 8/25/2009 6:32 PM (GMT -6)   
I want to say mine started way up and with each scope it looked like it was moving down my colon. Almost like it was 'on its way out'. It wasn't in my rectum until right before I went into remission. I could tell it was low too because I would get cramping way down below my belt line (female area...)
20 year old college student diagnosed with UC in March 2005
Remission since January/April 2006-->THREE YEARS!!!!!
Meds: 3 750mg Colazal 2x daily, 25mg Amitriptyline, 75mg Effexor XR for GAD, ortho lo
Seasonal allergies, very mild asthma (albuterol when needed), allergic to sulfa
"It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change"
Charles Darwin

Regular Member

Date Joined Jun 2007
Total Posts : 364
   Posted 8/25/2009 8:42 PM (GMT -6)   
My 10 year old has pancolitis, but the worst of her disease was on the right side with very little left side or rectal involvement at all. She had open sores on the right side, though. I too have the concern about it really being Crohn's, but biopsies and Prometheus test both say UC.

Good luck

(There is another similar thread going on talking about disease location on a thread started by Wha if you are interested)

Mom of Son 17 UC dx 07/02, Prednisone 2.5 mg, Lailda 2 am & 1 pm, Azasan 100mg, folic acid, L. Reuteri, Culturelle, Zyrtec, Iron, Vit/Min

Daughter 10 UC dx 08/07 Prednisone 2.5 mg, Colazal 750mg x 4, 6MP 12.5mg, Iron, Vit/Min., Culturelle

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