Learning about UC is the first step toward managing it. If you or a loved one is living with UC, understanding the
condition will help you discuss with your doctor.
Click one of the tabs below to start learning more about UC.
What is Ulcerative Colitis?
UC is a chronic disease that may cause bowel inflammation, diarrhea, and rectal bleeding. UC can be called
several things, depending on how the disease affects the large intestine, also known as the colon:
- Pancolitis, in which inflammation is present throughout the entire large intestine
- Distal colitis, which consists of left-sided colitis, ulcerative proctitis (UP), and ulcerative
proctosigmoiditis (UPS)
- UP is confined to the rectum
- UPS reaches higher into the colon
Ulcerative colitis only affects the colon. A similar disease, Crohn's disease, can affect any part of the
digestive tract.
Prevalence and Symptoms of Ulcerative Colitis
Up to 20 people per 100,000 are diagnosed with UC every year—typically when they are in their late teens or
twenties.
The most common symptoms of UC are diarrhea and rectal bleeding. Other symptoms of UC may include
- Fever
- Abdominal pain
- Weight loss
- Fatigue
- Anemia
- Signs of malnutrition, such as weakness, irritability, or dizziness
- Stunted growth in children and adolescents
UC symptoms come and go. It is very common for people to go months without experiencing symptoms. A span of
time without symptoms is called remission. When symptoms return, it is called a flare.
Causes of Ulcerative Colitis
Experts are still trying to discover the causes of UC. Much progress has been made, but more research needs
to be done. For now, only theories exist.
Many experts believe that UC is caused by an abnormal immune system. A healthy immune system protects
against harmful bacteria, but experts believe that the immune system of a person with UC may react
abnormally to otherwise normal bacteria in the digestive tract as well as to the lining of the intestines.1,2
UC isn't caused by stress or certain foods—although these factors may trigger symptoms in some people.
Genetics and certain environmental factors play roles in the development of UC. These environmental factors
can include infections, smoking, where you live in the world, sanitation, and taking certain
medications.†1,2
UC may be hereditary. Some people are genetically at greater risk for the condition, if the disease runs in
their families.1,2
Diagnosing Ulcerative Colitis
Because the symptoms of UC are similar to Crohn’s disease and other intestinal disorders, UC can be
difficult to diagnose.
Diagnosis of UC usually starts with a physical exam and medical history. A series of tests may be performed
to confirm UC and rule out other diseases.
- Flexible sigmoidoscopy and colonoscopy—these tests are the most accurate for
diagnosing UC. They both involve inserting a flexible tube into the anus. A small camera on the tube
sends a video feed back to the doctor. The doctor can see inflammation, bleeding, and ulcers on the
colon wall. During these procedures, the doctor may choose to perform a biopsy in which he or she
captures a piece of infected tissue. This tissue is examined by a lab to help make the diagnosis.
Sigmoidoscopies and colonoscopies are performed at a hospital or outpatient center. A light sedative or
pain medication is generally given to help you relax
- Barium enema—this test uses an x-ray to examine the large intestine. You are given
barium (a dye) as an enema, which coats the lining of the large intestine and rectum and then an x-ray
is taken to identify affected areas
- Small intestine x-ray—this test specifically examines the small intestine, which can’t
be seen through a colonoscopy. You drink a barium “shake” and the doctor takes an x-ray of the small
intestine. This test is used to help determine if you have UC or Crohn’s disease
Treatment for Ulcerative Colitis
UC can affect people differently, so there are a variety of treatment options that can be used to help keep
symptoms under control. Although treatment options vary, the goal is always to lessen the impact of flares.
Medications
There are several types of medication that can be used to treat UC:
- It is important to talk to your doctor about your treatment options.
- Aminosalicylates (5-ASAs)
- Corticosteroids
- Immunomodulators
- Biologic therapies
Below are additional therapies.
Surgery
In some cases, medication does not work in the treatment of UC. About one-quarter to almost half of people
with UC need surgery that involves the removal of the colon. This is known as a colectomy. Depending on
factors such as age and severity of the disease, one of two procedures may be performed. In the first
procedure, the entire colon and rectum are removed and an ileostomy, or external stoma, is created. This is
basically an opening in the abdomen through which wastes are emptied into an attached pouch. In the second
procedure, the colon is removed, but a part of the anus remains intact so normal bowel function can be
maintained.
Diet
In addition to therapy, you can actively manage your UC through an improved diet. Many people with UC find
that a low-fiber, low-fat diet reduces the incidence of diarrhea and potential flares. Eating fruits and
vegetables that are rich in antioxidants, like blueberries, cherries, and squash, could also reduce the
intensity of flares. Spicy foods; foods with a high fat-content, like chocolate; and foods with complex
carbohydrates, like beans, can be particularly aggravating.
Exercise
Exercise is an important component of everyone's health. It's vital that people with UC find an exercise
routine that works for them. Before beginning an exercise routine, be sure to talk to your doctor about what
activities would be best for you. Remember to drink plenty of water before, during, and after each workout.
Stress
For many, stress has a large impact on their UC symptoms. Relaxation techniques can help you gain control of
your symptoms and provide a much-needed break from the day-to-day stresses of living with UC. Yoga, tai chi,
and meditation may help reduce your response to stress. Deep breathing—breathing from your diaphragm—may
also help relax your abdominal muscles and promote good intestinal health.