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DigestiveICD-10: K51Affects approximately 600,000-900,000 people in the US

Ulcerative Colitis

Also known as: UC

Ulcerative colitis is a chronic inflammatory bowel disease that causes long-lasting inflammation and ulcers in the innermost lining of the large intestine and rectum. Symptoms typically develop over time and can include bloody diarrhea, abdominal pain, and an urgent need to have bowel movements. While there is no cure, treatment can significantly reduce symptoms and even bring long-term remission.

Symptoms

Diarrhea, often with blood or pus
Abdominal pain and cramping
Rectal pain and bleeding
Urgency to defecate
Inability to defecate despite urgency
Weight loss
Fatigue
Fever during flares
Failure to grow in children

Causes

  • Abnormal immune response attacking the colon lining
  • Genetic predisposition with multiple genes involved
  • Environmental triggers that are not fully understood
  • Possible role of gut microbiome dysbiosis

Risk Factors

  • Family history of inflammatory bowel disease
  • Age between 15 and 30 years, with a second peak between 50 and 70
  • White or Ashkenazi Jewish descent
  • Previous NSAID use may trigger or worsen flares

Diagnosis

  • Colonoscopy with biopsy showing characteristic mucosal inflammation
  • Blood tests for anemia, inflammation markers, and nutritional deficiencies
  • Stool tests to rule out infections and measure calprotectin
  • CT or MRI enterography to assess disease extent

Treatment

  • 5-aminosalicylates (mesalamine) for mild to moderate disease
  • Corticosteroids for acute flares
  • Immunomodulators such as azathioprine or 6-mercaptopurine
  • Biologic therapies including anti-TNF agents, vedolizumab, or ustekinumab
  • JAK inhibitors such as tofacitinib
  • Colectomy for severe or medication-refractory disease

Prevention

  • No known prevention for developing ulcerative colitis
  • Medication adherence to maintain remission and prevent flares
  • Regular colonoscopic surveillance for colorectal cancer

When to See a Doctor

  • Persistent diarrhea with blood
  • Abdominal pain that is ongoing or severe
  • Unexplained fever lasting more than a day or two
  • Inability to maintain adequate nutrition or hydration

Frequently Asked Questions

Related Conditions

Crohn's Disease

Autoimmune

Irritable Bowel Syndrome (IBS)

Digestive

Colorectal Cancer

Cancer

Celiac Disease

Autoimmune

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.