Ulcerative Colitis


Ulcerative colitis is a chronic (ongoing) disease of the colon, or large intestine that causes inflammation and ulceration of the colon inner lining. Pus, mucus and blood are excreted by ulcers, or tiny open sores, that form on the lining of the gastrointestinal tract. Ulcerative colitis usually begins with inflammation in the rectum and lower colon, but it may also involve the entire colon. To determine the diagnosis, your physician will evaluate the results of laboratory tests, X-rays and findings on endoscopy and pathology tests. The endoscopic examination examines the colon mucosal surface for disease changes. Any abnormal areas of the lining are diagnosed by the endoscopist, and pictures are taken. In addition, a small piece of the mucosa is sent to the pathology laboratory for a microscopic diagnosis. Other testing may need to be performed to eliminate other conditions. It may take some time to come to the proper diagnosis because the symptoms of ulcerative colitis mimic those of other gastrointestinal disorders including infectious causes of diarrhea.

Background Information

Ulcerative colitis and a related condition, Crohn’s disease, are the two main disease categories that belong to a larger group of illnesses called inflammatory bowel disease (IBD). It is estimated that nearly half of a million Americans have ulcerative colitis. The incidence of disease is similar with males and females. Crohn’s disease occurs primarily in individuals under the age of 30. It can, however, affect individuals of all ages.

Ulcerative colitis is a chronic disease and is associated with a slightly increased risk of small intestinal and colorectal cancer. As a result, patients with this disease need to be screened more closely by endoscopic and other methods, as determined by their physician

Individuals with ulcerative colitis can experience any range of symptoms ranging from mild to severe. The symptoms will range in severity depending on whether or not the disease is in a period of remission or flare up. Some of the symptoms an individual may experience are unexplained weight loss, diarrhea, fever and abdominal pain.

Risk Factors:
Individuals are at a higher risk of developing ulcerative colitis if they have a family member with the disease. There does not appear to be a clear-cut pattern to this inheritance and it is unknown which gene(s) is involved in the disease. Ulcerative colitis affects certain ethnic groups more than others. The environment is also thought to have some affect on increasing the risk of ulcerative colitis. Foreign substances may be the direct cause of the inflammation, or they may stimulate the body’s defenses to produce an inflammation that continues without control.

Follow-up and Treatment Options

The treatment for ulcerative colitis depends on the severity of disease, complications, and response to previous treatment. The goals of treatment are to control inflammation, correct nutritional deficiencies and relieve symptoms like abdominal pain, diarrhea and rectal bleeding. Most individuals with ulcerative colitis are treated with medication and some severe cases require surgery. Only a physician can determine the most appropriate treatment.

Drug Therapy:
The goal of drug therapy is to induce and lengthen remission periods and reduce the severity of symptoms. Anti-inflammatory drugs are almost often used to reduce the inflammation. In some situations, other medications may be appropriate to treat diarrhea, pain or infection.

Surgical removal of the colon or rectum may be necessary for patients who fail to respond to medical therapy or for those who have complications associated with the disease, such as cancer.

Questions to Ask Your Healthcare Provider
  • What treatment do you suggest?
  • What are the benefits of this type of treatment?
  • What are the risks and side effects of this treatment option?
  • Is there anything I should be doing or not doing during treatment?
  • What are the steps after treatment?
  • How should I manage my diet to reduce my symptoms?
Sources for Additional Information

The content of this web page and corresponding downloadable handout is provided to you as general information and not intended as a diagnosis. Please consult with your personal physician regarding the essential details about your condition. Updated 12/2013.

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