Ulcerative Colitis

Built by in-house doctors

What Is Ulcerative Colitis?

Ulcerative colitis, or UC, is a long-term inflammatory bowel disease that affects the rectum and colon. It causes inflammation and ulcers in the inner lining of the large intestine. Symptoms often alternate between flares, when the condition is active, and remission, when symptoms improve or disappear.

‍

What Causes Ulcerative Colitis?

The exact cause is not fully understood. UC is thought to develop when the immune system reacts abnormally and causes ongoing inflammation in the colon. Genetics, the gut microbiome and environmental factors may all contribute. UC is not caused by stress or by eating a particular food.

Types of Ulcerative Colitis

The type of UC depends on how much of the colon is affected. Ulcerative proctitis affects only the rectum. Proctosigmoiditis affects the rectum and the nearby sigmoid colon. Left-sided colitis extends along the left side of the colon, while extensive colitis, also called pancolitis, affects most or all of the colon.

‍

How Is Ulcerative Colitis Treated?

Treatment aims to reduce inflammation, control flares and maintain remission. Options may include aminosalicylates, short courses of corticosteroids, immunosuppressants, biologic medicines and targeted oral treatments. The most suitable option depends on the location and severity of inflammation, previous treatments and individual health needs.

Surgery may be considered when medicines do not control the condition, quality of life is severely affected or serious complications develop. Surgery usually involves removing the colon and rectum and creating either an internal pouch or a stoma through which stool can leave the body.

‍

Living With Ulcerative Colitis

Urgency, fatigue and uncertainty about toilet access can affect work, travel, relationships and social activities. Planning ahead, carrying necessary supplies and knowing where toilets are located can make some situations easier. Tracking bowel movements, bleeding, pain, medicines and symptoms outside the bowel can also make appointments more productive.

‍

Risks

Anyone can develop UC, including children and older adults, although it often begins in adolescence or early adulthood. Having a parent, sibling or child with inflammatory bowel disease increases the likelihood of developing it. Genes can affect susceptibility, but UC is not usually inherited in a predictable way, and there is currently no established method of preventing it.

UC can also increase the risk of blood clots and colorectal cancer, particularly when extensive inflammation has been present for many years. Regular monitoring can help identify changes early.

Symptoms

Common symptoms include recurring diarrhea, blood or mucus in the stool, abdominal pain, cramping and an urgent or frequent need to use the toilet. Some people feel they still need to have a bowel movement even when the bowel is empty, which is known as tenesmus. Fatigue, fever, nausea, loss of appetite and weight loss may occur when inflammation is more severe.

UC can sometimes affect other areas of the body. People may experience painful joints, skin changes, mouth ulcers, eye inflammation or problems affecting the liver and bile ducts. These symptoms may occur alongside bowel symptoms or develop separately.

Diagnosis

Diagnosis usually involves discussing symptoms and medical history, followed by blood and stool tests. A colonoscopy or flexible sigmoidoscopy with small tissue samples, called biopsies, is normally needed to confirm UC, determine how much of the colon is affected and rule out infections or other conditions.