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Ulcerative Colitis

Dr. Sulaiman Bin Yusof

MbChB (Sheffield) M.Med (Surg) FRCSEd (Gen Surg)
蘇萊曼·尤索夫博士
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Symptoms Causes Types Diagnosis Treatment Prevention FAQ
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Symptoms
Causes
Types
Diagnosis
Treatment
Prevention
FAQ

Ulcerative colitis is a chronic inflammatory bowel disease that affects the large intestine (colon) and rectum. This condition causes inflammation and ulcers in the digestive tract’s innermost lining, leading to ongoing intestinal inflammation.

The inflammation begins in the rectum and can extend continuously through the colon, causing tissue damage that can lead to frequent bowel movements, bleeding, and abdominal pain.

Symptoms of Ulcerative Colitis

Patients with ulcerative colitis may experience periods of active disease followed by periods of remission. Common symptoms include:

Bloody Diarrhoea: The most common symptom involves loose stools mixed with blood and mucus. The frequency can range from a few to many times per day.

Abdominal Pain: Patients experience cramping and discomfort, particularly in the lower abdomen. The pain often intensifies before bowel movements.

Urgency: Many patients feel a sudden, intense need to have a bowel movement. This urgency may be accompanied by an inability to hold bowel movements.

Fatigue: Chronic inflammation and possible blood loss may lead to anaemia, causing persistent tiredness and low energy levels.

Weight Loss: Reduced appetite and poor absorption of nutrients can result in unintended weight loss.

Extra-intestinal Symptoms: Some patients develop joint pain, skin problems, or eye inflammation. These symptoms occur when inflammation affects areas outside the digestive system.

Causes and Risk Factors

Several factors contribute to the development of ulcerative colitis. Common causes include:

  • Immune System Dysfunction

    An overactive immune system mistakenly attacks healthy cells in the digestive tract, leading to inflammation and tissue damage.

  • Genetic Factors

    A family history of ulcerative colitis increases the likelihood of developing the condition, indicating a hereditary influence.

  • Environmental Triggers

    External factors such as infections, stress, or dietary changes can initiate or worsen symptoms in individuals predisposed to the condition.

  • Age

    Although ulcerative colitis can occur at any age, it is most commonly diagnosed in people under 30.

Types of Ulcerative Colitis

Ulcerative colitis is classified based on the extent and location of inflammation within the colon.

Ulcerative Proctitis

Affects only the rectum, the area closest to the anus. This form tends to be the mildest, with symptoms including rectal bleeding, urgency, and tenesmus (a feeling of incomplete evacuation). Patients may achieve remission more easily compared to other types.

Left-sided Colitis

Inflammation extends from the rectum up through the sigmoid and descending colon. Patients experience left-sided abdominal pain, bloody diarrhoea, and weight loss. This form affects a significant portion of the colon but may respond well to topical and oral medications.

Extensive Colitis/Pancolitis

Involves the entire colon. Patients experience severe symptoms including frequent bloody diarrhoea, abdominal pain, significant weight loss, and fatigue. This form often requires more intensive medical treatment and carries a higher risk of complications.

Diagnostic Methods

Colonoscopy

A thin, flexible tube with a camera examines the entire colon and rectum. The procedure allows direct visualisation of inflammation and ulcers, and enables tissue sampling for biopsy. The appearance and pattern of inflammation help distinguish ulcerative colitis from other conditions.

Biopsy

Small tissue samples taken during colonoscopy undergo microscopic examination. The analysis reveals characteristic changes in tissue architecture and inflammatory patterns specific to ulcerative colitis.

Blood Tests

Blood samples check for anaemia, infection markers, and inflammatory indicators. These tests help assess disease severity and monitor treatment response, though they cannot diagnose ulcerative colitis alone.

Stool Tests

Laboratory analysis of stool samples rules out infections and measures levels of inflammatory markers. These tests help differentiate between infection and disease flare-ups.

Imaging Studies

CT scans or MRIs may show bowel wall thickening or complications. These imaging techniques provide additional information about disease extent and possible complications.

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Treatment Options

Non-Surgical Treatment
Medication

Treatment often involves anti-inflammatory drugs like 5-aminosalicylates (5-ASA) to reduce bowel inflammation, immunosuppressants to control the immune response, and biologics that target specific pathways in the inflammatory process, offering effective management for moderate to severe cases.

Surgical Treatment
Total Proctocolectomy

This procedure involves the complete removal of the colon and rectum, effectively eliminating the diseased tissue. Waste management is tailored to the patient’s condition and may involve creating an ileostomy, where waste exits the body through an external stoma into a bag, or an internal pouch constructed from the small intestine, allowing for more natural waste elimination.

J-Pouch Surgery

This procedure involves creating a J-shaped internal reservoir from the small intestine, allowing patients to maintain bowel continuity and function without an external bag. It is typically performed in multiple stages and is best suited for carefully selected patients who can tolerate the procedure and its recovery process.

Prevention and Management

Managing the condition involves medication adherence, dietary adjustments, and regular monitoring. Food diaries can help identify triggers, allowing healthcare providers to create personalised diet plans. Stress management through relaxation techniques may reduce flare-ups. Regular exercise, adequate sleep, and smoking cessation support overall health. Routine medical check-ups ensure effective monitoring and treatment adjustments.

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Dr. Sulaiman Bin Yusof

MbChB (Sheffield)

M.Med (Surgery)

FRCSEd (General Surgery)

蘇萊曼·尤索夫博士

Dr. Sulaiman Bin Yusof is a Senior Consultant colorectal and general surgeon in Singapore with over 15 years of specialist experience across public and private practice. Trained in the United Kingdom and awarded a Ministry of Health Fellowship to the Peter MacCallum Cancer Centre in Melbourne, he has built his practice around complex colorectal surgery, with robotic-assisted technique as his primary surgical platform for colectomy and anterior resection.

Patients consult Dr. Sulaiman for his depth of experience in colorectal cancer and perianal conditions, as well as for consultations that are thorough, unhurried, and focused on giving patients a clear understanding of their options.

Credentials & Fellowship Training

Dr. Sulaiman holds an MBChB from the University of Sheffield, a Master of Medicine in Surgery (M.Med), and a Fellowship of the Royal Colleges of Surgeons of Edinburgh in General Surgery (FRCSEd). He completed a Ministry of Health Fellowship at the Peter MacCallum Cancer Centre in Melbourne, one of the world’s foremost oncology institutions, serves as a Visiting Consultant at Changi General Hospital and has contributed eight peer-reviewed publications to medical literature.

Former Director of Endoscopy, Changi General Hospital

Dr. Sulaiman served as Director of Endoscopy at Changi General Hospital, overseeing one of Singapore’s busiest endoscopy units, and brings that public-sector depth of experience to his private practice. In this role, he led a high-volume diagnostic endoscopy service encompassing colonoscopy and gastroscopy across a broad and diverse patient population.

Academic Appointments & Teaching Awards

Dr. Sulaiman holds concurrent Adjunct Associate Professor appointments at the NUS Yong Loo Lin School of Medicine, Lee Kong Chian School of Medicine, and Duke-NUS Medical School. He has been recognised on the Dean’s Honour Roll for Teaching and received the Singapore Health Quality Service Star Award 2023, reflecting his contribution to both surgical education and clinical care.

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Contact Dr Sulaiman: Colorectal and General Surgeon in Singapore

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    Our Clinic Locations Across Singapore

    Gleneagles Medical Centre

    6 Napier Road #06-16
    Singapore 258499

    +65 6993 8624

    Mount Elizabeth Novena Hospital

    38 Irrawaddy Road, #10-48/49
    Singapore 329563

    +65 6643 9929

    Parkway East Hospital

    #05-08, 319 Joo Chiat Place
    Singapore 427989

    +65 6348 1383

    Mount Alvernia Hospital

    #08-62, Medical Centre D
    820 Thomson Road
    Singapore 574623

    +65 6250 0537

    Connexion

    Farrer Park Medical Centre #14-12
    1 Farrer Park Station Road
    Singapore 217562

    +65 6538 2790

    Frequently Asked Questions

    Can diet alone treat ulcerative colitis?

    While diet cannot cure ulcerative colitis, certain dietary modifications may help manage symptoms. Each person responds differently to foods, making individualised dietary plans necessary.

    Does ulcerative colitis increase the risk of other health conditions?

    Yes, patients with ulcerative colitis may have a higher risk of developing osteoporosis, liver diseases like primary sclerosing cholangitis (PSC), or blood clots. Regular monitoring helps address these risks early.

    How often should patients with ulcerative colitis have a colonoscopy?

    Patients with long-standing ulcerative colitis, especially pancolitis, are advised to undergo regular colonoscopies every 1-2 years to monitor for colorectal cancer, starting 8-10 years after diagnosis.