GI Health
|
July 27, 2023

Top Labs To Run Bi-Annually On Your Ulcerative Colitis Patients

Medically Reviewed by
Updated On
September 17, 2024

You may know what it's like to have an urgent bowel movement. Imagine that happening on a regular basis or not being able to have a bowel movement when you need to. These symptoms are common in patients struggling with Ulcerative colitis (UC). This gastrointestinal (GI) condition is responsible for over a quarter million doctor visits yearly in the U.S., and the number is growing. Therefore, patients with these conditions must have various solutions to manage this condition effectively. An essential part of providing solutions is assessing underlying factors contributing to the associated symptoms and disease progression. This article will provide insights into the top labs commonly used to help patients address UC.

[signup]

What is Ulcerative Colitis?

UC typically affects adults before they turn the age of thirty. UC is the prevailing GI disorder under the inflammatory bowel disease (IBD) umbrella. IBD consists of two inflammatory GI disorders, UC and Crohn's disease. Crohn's can affect all parts of the digestive tract. In contrast, UC is mucosal inflammation and ulceration that is limited to the colon. However, UC is still classified by its location in the colon. These classifications include inflammation in the rectum (Ulcerative proctitis), the rectum and sigmoid colon (Proctosigmoiditis), the rectum to the descending colon (Left-sided colitis), and the entire colon (Pancolitis).

What Causes Ulcerative Colitis?

The exact cause of UC is still undetermined. However, it is suggested that it arises from a combination of genetic, environmental, and immune system factors. Genetics may play a significant role, as there is a higher prevalence of UC with a family history of the disease. Researchers have identified over 100 gene loci associated with inflammatory bowel disease, including 23 specific to UC. 

Immune dysfunction is another contributing factor, with exaggerated immune responses targeting the large intestine tissues, and antibodies against colonic epithelial cells have been found in many individuals with UC. 

Dysbiosis, an imbalance in the gut microbiota, also plays a role in the development of UC. UC patients will often have a decrease in the diversity of the microbiome. Additionally, lifestyle factors like a Westernized diet may contribute to the risk of developing UC. Overall, there are multiple contributing factors to this condition.

Ulcerative Colitis Symptoms

Symptoms of UC can be gradual, and some patients will have random remissions and relapses. NSAID (nonsteroidal anti-inflammatory drug) use can aggravate symptoms. Although the most typical symptom of UC is bloody diarrhea that may or may not contain mucus, other symptoms depend on the severity and include:

  • A feeling of needing to pass a stool even after emptying
  • Urgent bowel movements
  • Abdominal pain
  • Fatigue
  • Decrease in weight
  • Fever

Extraintestinal (outside the intestines) manifestations can occur in up to 30% of UC patients. It is important to note that symptoms in the hepatic (liver) system signify an increased risk of colorectal cancer. The extraintestinal symptoms include:

  • Inflammation of the eye
  • Arthropathies (joint pain)
  • Cholangitis (Inflammation of the bile duct)

Top Labs To Run Bi-Annually On Your Ulcerative Colitis Patients

Before discussing the labs typically used regularly with UC patients, it's important to discuss how this condition is diagnosed. The antibody test for pANCA and ASCA (Anti-saccharomyces cerevisiae antibodies) can help differentiate Crohn's from UC as a preliminary option. The antibody for pANCA is present in up to 70% of UC patients, and ASCA is more prevalent in Crohn's. However, a definitive diagnosis and differentiation from other forms of IBD require a colonoscopy with biopsy. This procedure confirms and differentiates UC. With that stated, here are the top labs that should be considered to be completed on a bi-annual basis for UC:

Comprehensive Stool Test

This stool test is helpful in diagnosing UC and necessary in ruling out other pathogens that can cause similar symptoms. For example, Clostridium difficile infection is most common in patients with recent antibiotic exposure. Biomarkers such as fecal calprotectin and lactoferrin should also be added to the stool test bi-annually as they are elevated in active UC, reflecting inflammation and heightened white blood cell activity. Stool testing can be performed regularly to assess for microbiome imbalances contributing to symptoms associated with UC.

SIBO Breath Test

Research shows an increased prevalence of SIBO, small intestinal bacterial overgrowth, in patients with IBD and an occurrence of up to 19% in UC patients. The SIBO breath test can be completed at home to assess for SIBO. It involves fasting overnight, drinking a specialized mixture, and doing breath samples over 3-hours to assess for gases released from the bacteria associated with SIBO. Testing for SIBO can help patients with UC address and monitor underlying factors that may be contributing to their symptoms.

Food Sensitivities

Symptoms associated with food sensitivities can be tricky as they may occur hours or days after consuming certain foods. In the case of UC, approximately two-thirds of patients reported increased disease severity with food sensitivities. This food sensitivity panel measures antibodies in over 180 different foods and is completed by a finger prick or small blood sample. Regular testing for food sensitivities can be beneficial for UC to monitor any food reactions and associated symptoms and to personalize a dietary plan to eliminate foods that inhibit gut healing.

Inflammatory Markers

The markers of inflammation that should be tested regularly for Colitis patients are hs-CRP and ESR. These markers provide an understanding of the patient's disease profile and allow practitioners to track their inflammation. The hs-CRP is a high-sensitivity test and can assess for even minor inflammatory changes that can occur. ESR is another inflammatory marker that can be elevated in colitis patients. These tests can provide practitioners with information to target treatment approaches towards reducing inflammatory reactions in colitis patients, and regular monitoring can provide insights into treatment effectiveness.

Micronutrient Testing

Patients with IBD are prone to nutrient deficiencies due to absorption issues that can occur with this inflammatory digestive condition. Some of the nutrients these patients show frequent deficiencies in are Vitamins D, B12, and folate, which can impact how the body functions and various physiological processes. A micronutrient panel can provide regular screening on possible nutritional imbalances that may occur and provide patients with a specific dietary plan to address those imbalances.

[signup]

Summary

UC has multiple triggers; therefore, an integrative approach that can assess for those various triggers is an appropriate approach to help patients manage this condition. Relapses often occur, and patients can experience alleviation of their symptoms within days to weeks after adhering to a treatment protocol. Thus, regular monitoring and testing can help address these relapses and symptoms in UC patients so they can feel empowered and be proactive in their care.

You may know what it's like to have an urgent bowel movement. Imagine that happening on a regular basis or not being able to have a bowel movement when you need to. These symptoms are common in individuals managing Ulcerative colitis (UC). This gastrointestinal (GI) condition is responsible for over a quarter million doctor visits yearly in the U.S., and the number is growing. Therefore, individuals with these conditions must have various options to help manage this condition effectively. An essential part of providing options is assessing underlying factors contributing to the associated symptoms and condition progression. This article will provide insights into the top labs commonly used to help individuals address UC.

[signup]

What is Ulcerative Colitis?

UC typically affects adults before they turn the age of thirty. UC is the prevailing GI disorder under the inflammatory bowel disease (IBD) umbrella. IBD consists of two inflammatory GI disorders, UC and Crohn's disease. Crohn's can affect all parts of the digestive tract. In contrast, UC is mucosal inflammation and ulceration that is limited to the colon. However, UC is still classified by its location in the colon. These classifications include inflammation in the rectum (Ulcerative proctitis), the rectum and sigmoid colon (Proctosigmoiditis), the rectum to the descending colon (Left-sided colitis), and the entire colon (Pancolitis).

What Contributes to Ulcerative Colitis?

The exact cause of UC is still undetermined. However, it is suggested that it arises from a combination of genetic, environmental, and immune system factors. Genetics may play a significant role, as there is a higher prevalence of UC with a family history of the condition. Researchers have identified over 100 gene loci associated with inflammatory bowel disease, including 23 specific to UC. 

Immune system responses are another contributing factor, with exaggerated responses targeting the large intestine tissues, and antibodies against colonic epithelial cells have been found in many individuals with UC. 

Dysbiosis, an imbalance in the gut microbiota, also plays a role in the development of UC. UC patients will often have a decrease in the diversity of the microbiome. Additionally, lifestyle factors like a Westernized diet may contribute to the risk of developing UC. Overall, there are multiple contributing factors to this condition.

Ulcerative Colitis Symptoms

Symptoms of UC can be gradual, and some individuals will have random remissions and relapses. NSAID (nonsteroidal anti-inflammatory drug) use can aggravate symptoms. Although the most typical symptom of UC is bloody diarrhea that may or may not contain mucus, other symptoms depend on the severity and include:

  • A feeling of needing to pass a stool even after emptying
  • Urgent bowel movements
  • Abdominal pain
  • Fatigue
  • Decrease in weight
  • Fever

Extraintestinal (outside the intestines) manifestations can occur in up to 30% of UC patients. It is important to note that symptoms in the hepatic (liver) system signify an increased risk of colorectal cancer. The extraintestinal symptoms include:

  • Inflammation of the eye
  • Arthropathies (joint pain)
  • Cholangitis (Inflammation of the bile duct)

Top Labs To Consider Bi-Annually For Ulcerative Colitis Management

Before discussing the labs typically used regularly with UC patients, it's important to discuss how this condition is diagnosed. The antibody test for pANCA and ASCA (Anti-saccharomyces cerevisiae antibodies) can help differentiate Crohn's from UC as a preliminary option. The antibody for pANCA is present in up to 70% of UC patients, and ASCA is more prevalent in Crohn's. However, a definitive diagnosis and differentiation from other forms of IBD require a colonoscopy with biopsy. This procedure confirms and differentiates UC. With that stated, here are the top labs that could be considered to be completed on a bi-annual basis for UC:

Comprehensive Stool Test

This stool test is helpful in assessing UC and necessary in ruling out other pathogens that can cause similar symptoms. For example, Clostridium difficile infection is most common in patients with recent antibiotic exposure. Biomarkers such as fecal calprotectin and lactoferrin should also be added to the stool test bi-annually as they are elevated in active UC, reflecting inflammation and heightened white blood cell activity. Stool testing can be performed regularly to assess for microbiome imbalances contributing to symptoms associated with UC.

SIBO Breath Test

Research shows an increased prevalence of SIBO, small intestinal bacterial overgrowth, in individuals with IBD and an occurrence of up to 19% in UC patients. The SIBO breath test can be completed at home to assess for SIBO. It involves fasting overnight, drinking a specialized mixture, and doing breath samples over 3-hours to assess for gases released from the bacteria associated with SIBO. Testing for SIBO can help individuals with UC address and monitor underlying factors that may be contributing to their symptoms.

Food Sensitivities

Symptoms associated with food sensitivities can be tricky as they may occur hours or days after consuming certain foods. In the case of UC, approximately two-thirds of individuals reported increased condition severity with food sensitivities. This food sensitivity panel measures antibodies in over 180 different foods and is completed by a finger prick or small blood sample. Regular testing for food sensitivities can be beneficial for UC to monitor any food reactions and associated symptoms and to personalize a dietary plan to eliminate foods that may affect gut health.

Inflammatory Markers

The markers of inflammation that could be tested regularly for Colitis patients are hs-CRP and ESR. These markers provide an understanding of the individual's condition profile and allow practitioners to track their inflammation. The hs-CRP is a high-sensitivity test and can assess for even minor inflammatory changes that can occur. ESR is another inflammatory marker that can be elevated in colitis patients. These tests can provide practitioners with information to target approaches towards managing inflammatory reactions in colitis patients, and regular monitoring can provide insights into management effectiveness.

Micronutrient Testing

Individuals with IBD may experience nutrient deficiencies due to absorption issues that can occur with this inflammatory digestive condition. Some of the nutrients these individuals show frequent deficiencies in are Vitamins D, B12, and folate, which can impact how the body functions and various physiological processes. A micronutrient panel can provide regular screening on possible nutritional imbalances that may occur and provide individuals with a specific dietary plan to address those imbalances.

[signup]

Summary

UC has multiple triggers; therefore, an integrative approach that can assess for those various triggers is an appropriate approach to help individuals manage this condition. Relapses often occur, and individuals can experience alleviation of their symptoms within days to weeks after adhering to a management protocol. Thus, regular monitoring and testing can help address these relapses and symptoms in UC patients so they can feel empowered and be proactive in their care.

The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.

Learn more

No items found.

Lab Tests in This Article

  1. Lynch WD, Hsu R. Ulcerative Colitis. [Updated 2022 Jun 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459282/
  2. (2023, June 5). Retrieved July 12, 2023, from Rupa Health website: https://www.rupahealth.com/post/a-functional-medicine-ulcerative-colitis-uc-protocol-testing-nutrition-and-supplements
  3. 3 Natural Treatments For Inflammatory Bowel Disease. (2022, December 8). Retrieved July 12, 2023, from Rupa Health website: https://www.rupahealth.com/post/inflammatory-bowel-disease-ibd-treatments-for-flares-and-remission
  4. Sarlos, P., Kovesdi, E., Magyari, L., Banfai, Z., Szabo, A., Javorhazy, A., & Melegh, B. (2014). Genetic update on inflammatory factors in ulcerative colitis: Review of the current literature. World journal of gastrointestinal pathophysiology, 5(3), 304–321. https://doi.org/10.4291/wjgp.v5.i3.304
  5. Onuma, E. K., Amenta, P. S., Ramaswamy, K., Lin, J. J., & Das, K. M. (2000). Autoimmunity in ulcerative colitis (UC): a predominant colonic mucosal B cell response against human tropomyosin isoform 5. Clinical and experimental immunology, 121(3), 466–471. https://doi.org/10.1046/j.1365-2249.2000.01330.x
  6. Shen, Z. H., Zhu, C. X., Quan, Y. S., Yang, Z. Y., Wu, S., Luo, W. W., Tan, B., & Wang, X. Y. (2018). Relationship between intestinal microbiota and ulcerative colitis: Mechanisms and clinical application of probiotics and fecal microbiota transplantation. World journal of gastroenterology, 24(1), 5–14. https://doi.org/10.3748/wjg.v24.i1.5
  7. Shah, A, Morrison, M, Burger, D, et al. Systematic review with meta-analysis: the prevalence of small intestinal bacterial overgrowth in inflammatory bowel disease. Aliment Pharmacol Ther. 2019; 49: 624– 635. https://doi.org/10.1111/apt.15133
  8. Andrei, M., Gologan, S., Stoicescu, A., Ionescu, M., Nicolaie, T., & Diculescu, M. (2016). Small Intestinal Bacterial Overgrowth Syndrome Prevalence in Romanian Patients with Inflammatory Bowel Disease. Current health sciences journal, 42(2), 151–156. https://doi.org/10.12865/CHSJ.42.02.06
  9. M. Ballegaard, A. Bjergstrøm, S. Brøndum, E. Hylander, L. Jensen & K. Ladefoged (1997) Self-Reported Food Intolerance in Chronic Inflammatory Bowel Disease, Scandinavian Journal of Gastroenterology, 32:6, 569-571, DOI: 10.3109/00365529709025101
  10. Park, Y.E., Park, S.J., Park, J.J. et al. Incidence and risk factors of micronutrient deficiency in patients with IBD and intestinal Behçet's disease: folate, vitamin B12, 25-OH-vitamin D, and ferritin. BMC Gastroenterol 21, 32 (2021). https://doi.org/10.1186/s12876-021-01609-8
  11. Veauthier, B., & Hornecker, J. R. (2018). Crohn's Disease: Diagnosis and Management. American Family Physician, 98(11), 661–669. Retrieved from https://www.aafp.org/pubs/afp/issues/2018/1201/p661.html#diagnostic-studies-and-monitoring 
  12. Guh, A. Y., & Kutty, P. K. (2018). Clostridioides difficile Infection. Annals of internal medicine, 169(7), ITC49–ITC64. https://doi.org/10.7326/AITC201810020 
Order from 30+ labs in 20 seconds (DUTCH, Mosaic, Genova & More!)
We make ordering quick and painless — and best of all, it's free for practitioners.

Latest Articles

View more on GI Health
Subscribe to the Magazine for free
Subscribe for free to keep reading! If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Subscribe to the Magazine for free to keep reading!
Subscribe for free to keep reading, If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Trusted Source
Rupa Health
Medical Education Platform
Visit Source
Visit Source
American Cancer Society
Foundation for Cancer Research
Visit Source
Visit Source
National Library of Medicine
Government Authority
Visit Source
Visit Source
Journal of The American College of Radiology
Peer Reviewed Journal
Visit Source
Visit Source
National Cancer Institute
Government Authority
Visit Source
Visit Source
World Health Organization (WHO)
Government Authority
Visit Source
Visit Source
The Journal of Pediatrics
Peer Reviewed Journal
Visit Source
Visit Source
CDC
Government Authority
Visit Source
Visit Source
Office of Dietary Supplements
Government Authority
Visit Source
Visit Source
National Heart Lung and Blood Institute
Government Authority
Visit Source
Visit Source
National Institutes of Health
Government Authority
Visit Source
Visit Source
Clinical Infectious Diseases
Peer Reviewed Journal
Visit Source
Visit Source
Brain
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Rheumatology
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the National Cancer Institute (JNCI)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Cardiovascular Magnetic Resonance
Peer Reviewed Journal
Visit Source
Visit Source
Hepatology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Clinical Nutrition
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Bone and Joint Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Kidney International
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Allergy and Clinical Immunology
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Chest
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Neurology, Neurosurgery & Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Blood
Peer Reviewed Journal
Visit Source
Visit Source
Gastroenterology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Respiratory and Critical Care Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Diabetes Care
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of the American College of Cardiology (JACC)
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Clinical Oncology (JCO)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Clinical Investigation (JCI)
Peer Reviewed Journal
Visit Source
Visit Source
Circulation
Peer Reviewed Journal
Visit Source
Visit Source
JAMA Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
PLOS Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Nature Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The BMJ (British Medical Journal)
Peer Reviewed Journal
Visit Source
Visit Source
The Lancet
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the American Medical Association (JAMA)
Peer Reviewed Journal
Visit Source
Visit Source
Pubmed
Comprehensive biomedical database
Visit Source
Visit Source
Harvard
Educational/Medical Institution
Visit Source
Visit Source
Cleveland Clinic
Educational/Medical Institution
Visit Source
Visit Source
Mayo Clinic
Educational/Medical Institution
Visit Source
Visit Source
The New England Journal of Medicine (NEJM)
Peer Reviewed Journal
Visit Source
Visit Source
Johns Hopkins
Educational/Medical Institution
Visit Source
Visit Source

Hey Practitioners! Ready to become a world class gut health expert? Join Jeannie Gorman, MS, CCN, for a Free Live Class that dives into how popular diets impact the gut microbiome, the clinical dietary needs of your gut, biomarkers to test to analyze gut health, and gain a clear understanding of the Doctor’s Data GI360™ profile. Register here.