Ulcerative colitis

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 30, 2016
StartDiseasesUlcerative colitis

People who have ulcerative colitis live in constant discomfort and suffer from a plethora of digestive issues. It is a disease that does not discriminate against gender, age, or race. Experts are working every day to develop new treatments and medications.


Definition & Facts

Ulcerative colitis is a chronic inflammatory bowel disease that results in painful ulcers in the large intestine and rectum. It is considered an autoimmune disease because of the constant inflammation of the large intestine which is painful and unpredictable in most patients.

A study by the University of Michigan Health found that at least 600,000 people in America suffer from this debilitating condition. It can affect men and women at just about any age. Even though ulcerative colitis is in the same category as Crohn's disease, they are not the same. There are four types of ulcerative colitis, depending on the location in the large intestine that is affected.

Symptoms & Complaints

Ulcerative colitis will present similar symptoms in each of the four types. If the whole large intestine is involved, it is known as pancolitis and patients often suffer from fatigue, unintentional weight loss, severe pains in their abdomen, and bloody stools.

Left-sided colitis extends from the rectum to the location of the colon near the spleen and causes severe pain in the lower abdomen and often the rectum. Bloody diarrhea and weight loss are also common.

Proctosigmoiditis is a colitis that affects the upper rectum as well as the sigmoid colon. Those who suffer from this type have the abdominal pain and bloody stools, plus a constant urge to go to the bathroom. The fourth type, ulcerative proctitis, is localized in the rectum and may cause pain in the rectum and anus. It causes rectal bleeding and a constant urge to have a bowel movement.

All four types cause bleeding ulcers and chronic pain. Sufferers are limited in what they can eat and often avoid social situations because of frequent trips to the bathroom. Constant pain can also prevent them from doing the things that they have always enjoyed. Secondary infections, depression, and anxiety often accompany the typical symptoms of ulcerative colitis.


Medical experts are not sure what causes ulcerative colitis. As an autoimmune disorder, ulcerative colitis involves the malfunction of the immune system. If the immune system is waging war with a foreign virus or bacteria, it might accidentally attack gastrointestinal tract cells. As most patients report, symptoms of colitis can flare up at any given time.

Heredity may play a part in the cause. Caucasian people are more apt to have the disease. It is also strangely prominent in Ashkenazi people. Certain medications, such as isotretinoin, have been known to cause ulcerative colitis symptoms.

While not causes themselves, stress and inadequate nutrition exacerbate the condition. Certain foods, such as dairy and spicy dishes often inflame the colon of some colitis patients.

Diagnosis & Tests

There are several ways that a gastroenterologist can check a patient for ulcerative colitis. The doctor will do a complete physical examination and will get the patient’s medical history. He or she may order a colonoscopy, an extremely common test for colitis. While the patient is under anesthesia, the doctor runs a small camera mounted on a thin, pliable tube into the rectum which will show the doctor if there are inflammation, bleeding or ulcers anywhere in the intestines.

For a look at the upper part of the GI tract, the doctor can use an endoscope to enter the mouth and study the esophagus, stomach wall, and small intestines for signs of ulcerations. Another test involves swallowing a capsule with a microscopic camera. This camera will give the physician a complete map of the patient’s digestive tract. Later, the capsule will harmlessly pass from the bowels.

Standard lab tests from blood test and stool test can indicate infections, bacteria, and possible bleeding from the intestines. In more severe cases, the doctor may order CT scans, MRIs or other imaging tests. Specialists can usually give a diagnosis based on one or more of these tests.

Treatment & Therapy

How patients are treated for ulcerative colitis depends on the degree of the symptoms. For mild to moderate symptoms, the doctor will prescribe medication to counteract constant diarrhea. Enemas may also be beneficial. If inflammation is a problem, the doctor will usually prescribe a low-dose steroid for a period. Aminosalicylates can also be used to shrink swelling and to keep the disease at a minimum.

Doctors also work with their patients on a diet modification which avoids common trigger foods for colitis. In more severe cases, the doctor may recommend immunosuppressive drugs to prevent inflammation. When all other treatments are exhausted, the doctor may recommend that the colon is removed which can eradicate colitis.

Prevention & Prophylaxis

There are some steps people with ulcerative colitis can take that decrease how many times they suffer a flare-up of symptoms. Doctors and nutritionists have pinpointed specific foods and drinks that have the potential to cause flare-ups. Doctors recommend that people keep a food log for a while to see what kinds of food aggravates their colitis. Dairy products are a common culprit for ulcerative colitis patients. When they reduce or limit their dairy intake, many patients report improvement in their symptoms.

Alcohol and caffeinated drinks tend to irritate the colon, and should be avoided. Since people with colitis have a lot of trouble with digestion, doctors recommend that they limit fatty and greasy foods that take longer to digest and can cause diarrhea. Spicy foods are not the best for a sensitive colon lining either. High-fiber foods may also bulk up the intestines and worsen symptoms. Experts recommend that ulcerative colitis patients drink a lot of water, watch their nutrition, and get plenty of exercise.