Ulcerative Colitis: Symptoms, Causes and Treatments

Ulcerative Colitis: A chronic inflammatory bowel disease causing inflammation in the digestive tract. Explore symptoms, causes, and treatment options.

Ulcerative colitis is a long-term disease that inflames the large intestine’s lining. This disease, more common than others in its group, affects about a million people in the US.1 It can cause pain, lead to serious issues, and impact one’s daily life.

The exact reasons for why people get this condition are not fully known. But, experts think it could be due to how the body’s immune system reacts and your genes. When you have ulcerative colitis, you might notice signs like bloody stool, stomach ache, tiredness, and losing weight. Changing your diet, using medicines, or sometimes, having an operation can help manage it.

Key Takeaways

  • Ulcerative colitis is a chronic inflammatory bowel disease that affects the large intestine.
  • It is estimated that around 1 million Americans live with ulcerative colitis, making it the most common form of inflammatory bowel disease.
  • Symptoms can include bloody diarrhea, abdominal pain, fatigue, and weight loss.
  • The exact cause of ulcerative colitis is unknown, but it may involve an abnormal immune response and genetic factors.
  • Treatment options include dietary changes, medication therapy, and in severe cases, surgery.

Understanding Ulcerative Colitis

Ulcerative colitis is a long-term issue where the colon lining becomes inflamed.1 It causes sores and leads to other problems. About a million people in America have it, and it is more common in younger adults.1

What is Ulcerative Colitis?

This disease makes the large intestine’s inner lining inflamed and form sores.2 The body’s defense system attacks the colon’s lining, leading to ongoing inflammation and sores.2

Types of Ulcerative Colitis

Ulcerative colitis has different forms, affecting the colon in various ways.3 It often starts at the rectum and can spread to different parts. This includes affecting the entire colon.3


Proctitis is when the inflammation is only in the rectum.3 It can cause pain, bleeding, and a strong need to use the bathroom.


In Proctosigmoiditis, inflammation is from the rectum to the sigmoid colon.3 Symptoms might include seeing blood in the stool and stomach cramps. People might also feel like they need to use the bathroom but can’t.

Left-Sided Colitis

In Left-sided colitis, only the left side of the colon is inflamed.3 Symptoms include bloody stool, abdominal pain, and losing weight.


Pancolitis inflames the whole colon.3 It can lead to severe symptoms like lots of bloody diarrhea and fever.

Acute Severe Ulcerative Colitis

This form is life-threatening, affecting the entire colon.3 It causes heavy bleeding in the stool and dehydration. People with it are at high risk of severe complications.

Type of Ulcerative ColitisDescriptionSymptoms
ProctitisInflammation limited to the rectumRectal pain, bleeding, frequent urge to have a bowel movement
ProctosigmoiditisInflammation extends from the rectum to the sigmoid colonBloody diarrhea, abdominal cramps, feeling of incomplete bowel movements
Left-Sided ColitisInflammation confined to the left side of the colonBloody diarrhea, abdominal pain, weight loss
PancolitisInflammation affects the entire colonFrequent, bloody diarrhea, abdominal pain, fever, increased risk of complications
Acute Severe Ulcerative ColitisRare, life-threatening form affecting the entire colonSevere, bloody diarrhea, dehydration, risk of perforated colon or toxic megacolon

Symptoms of Ulcerative Colitis

The main signs of ulcerative colitis are bloody diarrhea, stomach pain, cramping, tiredness, and weight loss.1 Initially, bloody diarrhea is a common first sign. It might happen often or just sometimes. This issue can lead to abdominal pain and a sudden need to go to the bathroom.

Bloody Diarrhea

Bloody diarrhea stands out as a major sign of ulcerative colitis. The signs can be from mild to very strong.1 Many people notice this symptom at the start.

Abdominal Pain and Cramping

People with ulcerative colitis often feel stomach pain and cramps. These can happen because the colon is inflamed. Also, there’s sometimes a sudden need to use the bathroom.

Fatigue and Weight Loss

Fatigue and losing weight without trying are common in this condition.1 This is because the body doesn’t absorb nutrients well. These issues can make a person feel very tired and lose weight.

Other Potential Symptoms

There could be other symptoms too, like fever, joint pain, skin sores, and eye problems.1 Symptoms change from person to person, affecting their daily life in different ways.

ulcerative colitis symptoms

Causes and Risk Factors

The main cause of ulcerative colitis is not fully clear. But, it seems to happen when the immune system attacks the colon’s lining. This immune response is not correct and causes damage.1 Family history can also raise someone’s risk of getting it. If a close relative has ulcerative colitis, your risk may increase.4

Autoimmune Response

Ulcerative colitis is seen as an autoimmune disease. Here, the immune system wrongly hurts the large intestine’s wall. This leads to swelling and sores. The flawed immune response is a major cause of the disease.1

Genetic Predisposition

If you have a close relative with ulcerative colitis, your chances of getting it go up. This is particularly true if it’s a parent, sibling, or child.4 Some genes can make certain people more likely to have this immune problem.

Age and Ethnicity

Your age and where your family is from can affect your risk too. Most often, this disease shows up between ages 15 and 30, and also after 60.4 People from Ashkenazi Jewish families face a higher risk than others.5

Certain things in the environment, like some bacteria or chemicals, might start the disease. Also, lifestyle choices matter. Being inactive, and especially smoking, can increase your chances.5

Diagnosis of Ulcerative Colitis

Diagnosing ulcerative colitis means looking at a person’s medical past, examining them physically, and running tests. These tests are important. They help doctors see how serious the disease is and if it is actually colitis. They also make sure nothing else might be causing the symptoms.

Blood Tests

Blood tests are vital in spotting ulcerative colitis and any problems it brings, like anemia.6 They also pick up on signs of inflammation, infection, or other health problems. These could all be linked to the symptoms.

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Stool Tests

Stool tests help find out what else might be causing the symptoms, not just ulcerative colitis, like infections.6 They’re also key in finding signs of swollen intestines, which is a big clue to ulcerative colitis.7

Endoscopic Procedures

Procedures like colonoscopy let doctors see the inside of the colon and take samples for testing.6 This is a major step in diagnosing ulcerative colitis and figuring out how bad it is.7

Imaging Tests

Imaging tests give more info. X-rays and scans show how much the colon is swollen. They also look for any other problems from the colitis.7

Looking at a patient’s history, checking them out, and doing tests work together. They help doctors make a certain diagnosis of ulcerative colitis. With these, doctors can plan the right treatments.6

Ulcerative colitis diagnosis

Diagnostic TestPurpose
Blood TestsThey look for anemia, signs of infection, or inflammation to help diagnose ulcerative colitis.7
Stool TestsThese tests find certain cells or proteins that suggest ulcerative colitis.7
Endoscopic ProceduresThey let doctors see inside and take samples to confirm ulcerative colitis.7
Imaging TestsThey show how swollen the colon is and check for problems from the colitis.7

Treatment Options for Ulcerative Colitis

Treating ulcerative colitis is about managing inflammation, easing symptoms, and staying in remission. This involves changing what you eat, using medications, and sometimes surgery.

Dietary Changes

Eating the right food is key to handling ulcerative colitis.8 A good diet can lessen symptoms, make up for lost nutrients, and aid healing.8 It helps to cut down on dairy, eat less at a time, and drink plenty of water.

Medication Therapy

9For those with mild to moderate cases, doctors often start with aminosalicylates (5-ASAs).9 These are drugs you can take by mouth, as a suppository, or enema. They work by reducing inflammation.8 These medications also help heal the colon, easing symptoms like diarrhea and abdominal pain.8

9Corticosteroids are another option for inflammation, but they come with side effects. These can include acne, gaining weight, and mood changes.9 Immunosuppressants like tacrolimus and azathioprine are also used, but they might raise the chance of infections.9 In more severe cases, biologic drugs and newer options like JAK inhibitors and Ozanimod are available.9

8Combining different types of treatments, like a biologic plus an immunosuppressant, might work better. Still, it could also mean more side effects.89Clinical trials are researching better therapies for ulcerative colitis. They aim to improve life quality and find new treatments.9


9If medications don’t work or if the symptoms are severe, surgery might be the next step.98For a significant number of patients, about 25% to 33%, surgery is needed when other treatments fail or if they face complications.8

Working with doctors and trying different treatments can help people with ulcerative colitis find what works for them. This can lead to long-term remission.

Managing Ulcerative Colitis

Taking care of ulcerative colitis includes more than just medicine. It means changing parts of your life and learning to manage stress. Avoiding certain foods, like fried stuff, dairy, alcohol, and caffeine, can make you feel better when things get tough.10 Also, eating small meals often and drinking lots of water can help.10

Lifestyle Adjustments

For ulcerative colitis patients, keeping clean and choosing the right food is key.10 This might mean eating less high-fiber and dairy. On top of this, staying active boosts health and the body’s defenses.11

Stress Management

Although it doesn’t directly cause the disease, being stressed can make ulcerative colitis worse.10 To help, try out stress-busting things like working out, relaxation, or meditation. These can calm your mind and help your gut work right.10

Support Groups

Joining support groups and talking to a counselor can do a lot for your mental well-being when you have ulcerative colitis. It’s comforting to connect with others facing similar challenges. This can offer a feeling of belonging and understanding.

Ulcerative Colitis and Complications

Ulcerative colitis is a problem in the gut that keeps coming back. It can cause serious problems needing quick care. A big issue is colon bleeding, which might make you less red blood cells. This means you could feel tired and weak. People with this disease might also get osteoporosis, which makes their bones weak. This can happen because of not getting enough good food or from taking steroids to control the colitis.


Bad diarrhea from ulcerative colitis can make you lose a lot of water. This can mess up the salt in your body and even make you go into shock if you don’t fix it1. It’s very important to drink enough water and keep your salts right to stop this from happening.

Colon Cancer Risk

Ulcerative colitis makes the chance of getting colon cancer higher, mainly if the whole colon is sick or if you’ve had it for long12. Getting checked with a colonoscopy regularly is key to beat this risk early on.

It’s very important to find out and treat ulcerative colitis quickly. This helps stop or lower the chance of getting these bad problems112. Working with doctors closely lets people with ulcerative colitis manage their disease better and avoid these tough situations.

Ulcerative Colitis in Children

[Ulcerative colitis in children] can stir up in kids and teens too, showing symptoms much like those in grown-ups.13 Normally, it strikes people between 15 and 30 years old, but kids and older folks can get it too.13 It affects both boys and girls the same.13

Detecting it early and treating it right are key to kids’ healthy growth when dealing with [ulcerative colitis in children].13 Surgery might be needed for about 1 in 4 to 2 in 50 kids with this condition.13 Sadly, in extreme cases, it can be fatal, especially if it spreads beyond the lower colon.13

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14 Most cases show up in the mid-30s, but it’s not uncommon for it to hit at any age, even childhood.14 Kids with this illness may see times of feeling fine and then have moments of bad symptoms.14

14 Signs of [ulcerative colitis in children] can include bloody diarrhea, tummy ache, and not being able to hold in bowel movements.14 They might not feel like eating, lose weight, and feel tired.14 Other possible symptoms are skin problems, achy joints, and fevers.14

13 A quarter of kids needing serious hospital treatment for the disease is not unusual.13 Doctors use different tests to diagnose it, from blood work to looking inside the body with a scope.13

13 It can lead to serious issues like colon cancer and severe bleeding.13

14 The focus in treating [ulcerative colitis in children] is making a plan just for them. The aim is to make them feel better, stop flare-ups, and heal.14 Doctors may suggest different medications or even surgery. But, making sure they eat well is always important for their recovery.14

14 For some kids with [ulcerative colitis in children], surgery might be the best option if medicines and food changes don’t work anymore.14

Ulcerative Colitis and Mental Health

Dealing with ulcerative colitis greatly affects one’s mental health. Many patients face anxiety and depression.15 This includes about one-third experiencing anxiety and a quarter depression.15

The condition’s chronic nature and unexpected symptom flare-ups add to these challenges. The effect on social life and lifestyle is also important.15 Even those recently diagnosed may experience anxiety or depression.15 A study in 2015 showed a link between these mood disorders and ulcerative colitis.15

Anxiety and Depression

People with ulcerative colitis often suffer from fatigue,15. Doctors might recommend anticonvulsants for nerve pain.1516 Women with this condition tend to feel more anxious and depressed than men.16

If you have ulcerative colitis, you might experience symptoms such as low mood, loss of interest, and headaches.15 Anxiety symptoms could include nausea, sweating, and difficulty breathing.15

16 Studies indicate that your gut health can influence your emotions and immune system.16 Practices like diaphragmatic breathing for 5-15 minutes can help reduce anxiety.16 Meditation and exercise are known to lower anxiety and depression.16 Insomnia may raise the risk of depression and inflammation levels.16 Exercising in natural surroundings is better for reducing anxiety than indoors.16

Seeking Professional Help

It’s important to seek help from mental health experts who understand ulcerative colitis. They can greatly help with emotional and psychological management.15 It’s also useful to have social support and set achievable goals. A regular daily routine and avoiding too much alcohol and caffeine benefit mental health.1516 If you’re feeling suicidal, the National Suicide Prevention Lifeline offers immediate help at 1-800-273-8255.16

Advances in Ulcerative Colitis Research

Big progress is happening in how we deal with ulcerative colitis. We’re looking into new drugs, such as biologics and JAK inhibitors. These treatments are giving us hope for better results and staying in remission.17

New Treatment Options

There are many new drugs being developed for moderate to severe UC. They are in advanced stages of testing. Some examples are Janus kinase inhibitors and TNF-like ligand 1A inhibitors. A unique approach is combining two biologic therapies.17

Also, traditional drugs like TNF blockers and vedolizumab are recommended by many. These are suggested to help bring about remission.17

There’s talk about checking how well drugs work for each person. Some say we should regularly check on patients using the newest drugs. These include vedolizumab and ustekinumab.17

Ongoing Clinical Trials

Many ongoing studies are looking for better ways to treat ulcerative colitis. This research aims to boost the quality of life for patients.18

One trial found that the biosimilar CT-P13 works as well as infliximab in Crohn’s patients.18 Another trial found a new oral anti-TNF drug to be effective for ulcerative colitis.18

Integrin inhibitors, like vedolizumab, are also being looked at. This drug and others seem to work well for both starting and keeping up treatment.18 There is also interest in new kinds of drugs, such as AJM300, which may help prevent more severe colitis.18

The way we treat moderate to severe UC is changing. This could bring better results for patients. But it also means healthcare workers need to keep learning about these new options.17

Living with Ulcerative Colitis

Living with ulcerative colitis means carefully balancing symptoms and treatment.19 It’s vital to work with a doctor to stay in remission. This includes using medicines, changing your diet, and adapting how you live.

Maintaining Remission

Getting symptoms under control is key for people with ulcerative colitis.20 Before changing your diet, always talk to your healthcare provider. Exercise, relaxation, and open communication can cut down on stresses that cause flare-ups.20 Writing down what you eat might uncover foods that make your condition worse. Staying away from these foods could help keep your symptoms in check.

Coping Strategies

20 Exercise and staying relaxed can lessen how often you get symptoms.

Also,20 keeping track of what you eat can help you manage any discomfort better.

Support Networks

Support from loved ones and others who share your condition is incredibly important. This can improve your emotional well-being and overall quality of life.20 Joining support groups and talking to a counselor can help with the feelings this condition brings.

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Key Factors for Living with Ulcerative ColitisDetails
Maintaining Remission
  • 20 Consult care team before dietary changes
  • 20 Stress management techniques
  • 20 Food diary to identify trigger foods
Coping Strategies
  • 20 Stress management through exercise, relaxation, and communication
  • 20 Food diary to identify and eliminate trigger foods
Support Networks
  • Family and friends
  • Patient support groups
  • Counseling and mental health professionals

Ulcerative Colitis: Symptoms, Causes and Treatments

Ulcerative colitis is a long-term issue in the gut that causes swelling and sores in the large intestine’s lining.1 It impacts about 1 million folks in the U.S., making it the primary type of gut inflammatory disease.1 Its exact cause isn’t fully clear, but it probably comes from a mix of unusual immune reactions and genes.1

Its signs often include bloody poo, tummy pain, feeling tired, and dropping weight.1 Most folks get diagnosed before they’re 30.1 People of white descent, especially Ashkenazi Jews, have a higher chance of getting it.1 If someone in your direct family already has it, your chance also goes up.1

To treat it, the goal is to lower swelling, ease signs, and keep it calm.1 This might mean changing what you eat, taking meds like anti-inflammatory drugs and immune system dampeners, or, in bad cases, having surgery.1 Unfortunately, there’s no sure way to completely get rid of it. Many who deal with it will have times when they feel okay, but then the symptoms might come back.4

Changing how you live can also make a big difference. Keeping a food journal, cutting down on dairy, eating small but frequent meals, and always making sure you drink enough water help.1 Also, steer clear of things that set off your symptoms, find ways to chill out, and if you need, talk to someone about the impact on your mental health.1

Bloody DiarrheaThe main symptom of ulcerative colitis, often accompanied by other issues like cramping belly pain, weight loss, fatigue, joint pain, and fever.4
Abdominal Pain and CrampingFrequent and severe abdominal pain and cramping are common in individuals with ulcerative colitis.1
Fatigue and Weight LossUlcerative colitis can lead to fatigue and unintentional weight loss due to factors like inflammation, malnutrition, and loss of appetite.1
ComplicationsUlcerative colitis can also lead to complications such as severe dehydration, bone loss, and an increased risk of colon cancer.1


Ulcerative colitis is a tough condition, but things are improving. Many people with UC can go into long-term remission. They can improve their lives greatly. Each year, about a quarter-million people in the U.S. see their doctor because of UC. It costs more than four billion dollars in medical expenses.21 By knowing the symptoms, causes, and treatment choices, those with UC can lead the way to managing their health. They can work closely with their healthcare team. This partnership is vital for a good, long-term plan.

About 9 to 20 people out of every 100,000 get UC each year. The overall number of cases is between 156 to 291 people per 100,000 annually.21 It often starts affecting people between 15 and 25 years old. There’s another spike in cases between 55 and 65 years old.22 If someone in your family has UC, you face a higher risk too. Being informed and making positive choices can help with managing UC and feeling better.

Thanks to ongoing research, things are looking up for UC patients. There are more and better treatment options now. Understanding the disease better and creating strong support are key to helping people with UC. This support paves the way for long-term remission and a better life quality for all.


What is ulcerative colitis?

Ulcerative colitis is a type of bowel disease. It inflames and makes sores in the colon’s lining.

What are the different types of ulcerative colitis?

Types include proctitis (only the rectum’s inflamed), and proctosigmoiditis (rectum and lower colon). There’s also left-sided colitis affecting the left colon, pancolitis across the whole colon, and a severe form called acute severe ulcerative colitis.

What are the primary symptoms of ulcerative colitis?

Symptoms are often bloody diarrhea, belly pain, feeling tired, and losing weight without trying.

What causes ulcerative colitis?

The cause isn’t clear, but it looks like the body’s immune system fighting the colon’s lining. Genes might also matter.

How is ulcerative colitis diagnosed?

Diagnosis needs talking about your health, a check-up, blood and stool tests, and looking inside the colon. Imaging tests also help.

What are the treatment options for ulcerative colitis?

Treatments aim to ease inflammation and symptoms, and keep the disease from coming back. They can include changing what you eat, medicine, or surgery.

How can ulcerative colitis be managed?

Managing it means changing your life, handling stress better, and leaning on loved ones and groups for support.

What are the potential complications of ulcerative colitis?

It can lead to serious problems like anemia from bleeding, brittle bones, bad dehydration, and a higher chance of colon cancer.

Can ulcerative colitis affect children?

Yes, kids and teens can get it, too. Their symptoms usually look like what grown-ups have.

How does ulcerative colitis impact mental health?

It’s tough on the mind, often causing a lot of anxiety and depression. Getting help from mental health experts is key for dealing with this side of the disease.

What advancements are being made in ulcerative colitis research?

Scientists are looking into new drugs, like biologics and JAK inhibitors, that could really help. There’s also a lot of work going on in clinical trials to find more ways to treat and manage the disease.

Source Links

  1. https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/symptoms-causes/syc-20353326
  2. https://www.crohnscolitisfoundation.org/patientsandcaregivers/what-is-ulcerative-colitis/overview
  3. https://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/colitis-ulcerative-colitis-difference
  4. https://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/what-is-ulcerative-colitis
  5. https://www.uhhospitals.org/services/Digestive-health-services/Conditions-and-treatments/small-and-large-intestine/ulcerative-colitis
  6. https://www.niddk.nih.gov/health-information/digestive-diseases/ulcerative-colitis/diagnosis
  7. https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/diagnosis-treatment/drc-20353331
  8. https://www.crohnscolitisfoundation.org/patientsandcaregivers/what-is-ulcerative-colitis/treatment-options
  9. https://www.nhs.uk/conditions/ulcerative-colitis/treatment/
  10. https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/in-depth/ulcerative-colitis-flare-up/art-20120410
  11. https://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/managing-ulcerative-colitis
  12. https://www.nhs.uk/conditions/ulcerative-colitis/complications/
  13. https://www.stanfordchildrens.org/en/topic/default?id=ulcerative-colitis-in-children-90-P02020
  14. https://www.chop.edu/conditions-diseases/ulcerative-colitis-in-children
  15. https://www.medicalnewstoday.com/articles/ulcerative-colitis-and-mental-health-link
  16. https://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/ulcerative-colitis-mental-health
  17. https://www.ncbi.nlm.nih.gov/books/NBK595119/
  18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10441644/
  19. https://www.crohnscolitisfoundation.org/sites/default/files/legacy/assets/pdfs/living-with-ulcerative.pdf
  20. https://www.nhs.uk/conditions/ulcerative-colitis/living-with/
  21. https://www.ncbi.nlm.nih.gov/books/NBK459282/
  22. https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/ulcerative-colitis