Ulcerative Colitis

Not to be confused with Crohn's Disease, another inflammatory bowel disease, ulcerative colitis causes immune system damage to the colon only. Medical treatments exist, but colectomy is curative.

Ulcerative Colitis Overview

Reviewed: July 21, 2014

Ulcerative colitis is a disease that causes inflammation of the lining of the large intestine, which includes the colon and rectum. It is a group of diseases called inflammatory bowel disease.

The disease can begin in the rectal area, but may involve the entire large intestine over time. However, it may also begin in the rectum and other parts of the large intestine at the same time.

About half of people with ulcerative colitis have mild symptoms. In ulcerative colitis, the inflammation causes loss of the lining of the colon, which can cause pain in the stomach and blood or pus in the diarrhea.

The cause of ulcerative colitis is unknown. However, people with this condition usually have problems with their immune system.

Treatment may include medications. In some cases, people may be free of symptoms for long periods of time.

There is no known prevention for this condition and curing of ulcerative colitis is only possible through the complete removal of the large intestine.

Ulcerative Colitis Symptoms

The symptoms can be more or less severe. They may start slowly or suddenly. About half of people only have mild symptoms. Others have more severe attacks that occur more often. Many factors can lead to attacks.

Symptoms include:

  • Stomach pain
  • A gurgling sound heard over the intestine
  • Blood and pus in the stools
  • Diarrhea
  • Fever
  • Feeling that you need to pass stools, even though you already went
  • Loss of weight or loss of appetite
  • Anemia
  • Feeling tired

Children's growth may slow.

Other symptoms that may occur with ulcerative colitis may include the following:

  • Joint pain and swelling
  • Mouth ulcers
  • Nausea and vomiting
  • Ulcers on the skin

Ulcerative Colitis Causes

The cause of ulcerative colitis is unknown. However, people with this condition may have problems with their immune system.

Ulcerative colitis may affect any age group. Ulcerative colitis usually develops between the ages of 15 and 30 and less frequently between the ages of 60 and 80.

Risk factors for ulcerative colitis may include a family history of ulcerative colitis or Jewish ancestry.

Ulcerative Colitis Diagnosis

Doctors can order a colonoscopy with biopsy to diagnose ulcerative colitis.

The following tests may be also be done to help diagnose ulcerative colitis:

  • Computerized tomography (CT) scan and Barium enema x ray
  • Complete blood count (CBC)
  • C-reactive protein (CRP)
  • Sed rate (ESR)
  • Stool test

Living With Ulcerative Colitis

Diet and Nutrition

Certain types of foods may worsen diarrhea and gas symptoms. This problem may be more severe during times of active disease. Diet suggestions include:

  • Eat smaller meals more often throughout the day.
  • Drink plenty of water (drink small amounts throughout the day).
  • Avoid carbonated drinks.
  • Avoid high-fiber foods (bran, beans, nuts).
  • Avoid fatty, greasy or fried foods and sauces (butter, margarine).
  • Limit milk products if you are lactose intolerant.

For people with ulcerative colitis and who do not absorb enough nutrients, vitamin and nutritional supplements may be prescribed.


Ulcerative colitis may be associated with feelings of worrying, embarrassment, and even sadness. In addition, stressful events in your life can cause issues with your digestive. Managing your stress is important in managing ulcerative colitis.

Support Groups

There are support groups which can help you cope with ulcerative colitis.

Ulcerative Colitis Treatments

Treatment for ulcerative colitis will depend on how severe the disease and symptoms are.

The goals of treatment are to:

  • Control and prevent acute attacks
  • Help the colon heal


Medications can not cure ulcerative colitis but can help reduce symptoms. The following medications can be given to reduce the number of attacks:

  • 5-aminosalicylates such as mesalamine or sulfazine, help control inflammation. Some forms of the drug are taken by mouth; others must be inserted into the rectum.
  • Immunomodulators, such as azathioprine (Imuran, Azasan), 6-mercaptopurine (6-MP) (Purinethol), and cyclosporine (Neoral, Sandimmun, Sandimmune), suppress the immune system.
  • Corticosteroids, such as prednisone, methylprednisone, and hydrocortisone, also reduce inflammation.
  • Infliximab (Remicade) ia another treatment option for those who do not respond to the other treatments.
  • Acetaminophen (Tylenol) may help relieve mild pain.
    • Avoid medications such as, aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn), as these can make your symptoms worse.

Your doctor may prescribe other medications to decrease emotional stress, reduce diarrhea, or to treat infections.


About 10 to 40 percent of people with ulcerative colitis will require removal of the rectum and part or all of the colon.

Surgery to remove the colon will cure ulcerative colitis and remove the threat of colon cancer. Surgery may be anoption if you have any of the following:

  • Colitis that does not respond to complete medical therapy
  • Changes in the lining of the colon that can lead to cancer
  • Colon rupture, severe bleeding, or toxic megacolon

Most of the time, the entire colon, including the rectum, is removed. After surgery, you may have an opening in your belly called the stoma (ileostomy). In this case, stool will drain out through this opening. In addition, you may require a procedure to connect the small intestine to the anus in order to gain more normal bowel function.

You may require treatment in a hospital for severe attacks.

Ulcerative Colitis Other Treatments

Researchers are studying how and why the immune system is activated in ulcerative colitis, how it damages the colon, and the processes involved in healing. Researchers are looking for new and more specific therapies for ulcerative colitis.

Ulcerative Colitis Prognosis

About half of people with ulcerative colitis have mild symptoms. More severe symptoms are less likely to respond well to medicines.

With each decade that passes after the diagnosis of ulcerative colitis, the risk of colon cancer increases. The chances for small bowel and colon cancer increases with ulcerative colitis. Your doctor will recommend colon cancer screening.

Most people with ulcerative colitis never develop colon cancer. However, the duration of the disease and how much of the colon is affected, increases the risk.

There is no known prevention for this condition. Curing ulcerative colitis is only possible through complete removal of the large intestine. Surgical removal of the colon removes the risk of colon cancer.