Ulcerative colitis symptoms & treatment

Ulcerative colitis is an incurable form of inflammatory bowel disease (IBD) that causes the innermost lining of the colon and rectum to become inflamed and ulcerated, resulting in severe diarrhea and abdominal pain. Ulcerative colitis is caused by an abnormal response from your body's immune system.

Talk to your doctor if you have diarrhea plus stomach pain, blood in your stool or a fever that lasts more than a couple of days or that doesn’t get better with over-the-counter medications.

Ulcerative colitis risk factors and causes

Several factors can contribute to your chances of getting ulcerative colitis. The most common risk factors and causes include:

Genetics: People with a family history of ulcerative colitis are at higher risk of this disease.
Age: Ulcerative colitis usually begins before age 30, but it can develop at any age.
Race or ethnicity: Caucasians have the highest risk of ulcerative colitis, although people of any race can get it. People of Ashkenazi Jewish descent have an even higher risk of ulcerative colitis.

Ulcerative colitis symptoms

Abdominal pain and cramping
Diarrhea, often with blood or pus
Fatigue
Fever
Inability to defecate despite urgency
Urgency to defecate
Rectal bleeding – passing a small amount of blood with stool
Rectal pain
Weight loss

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Types of ulcerative colitis

There are different types of ulcerative colitis and symptoms based on the location of inflammation within the colon or rectum. The types of ulcerative colitis include:

Fulminant colitis: This is the rarest and most severe form of ulcerative colitis. It can cause extreme diarrhea, dehydration and shock, and it can be life-threatening.
Left-sided colitis: The inflammation of this type extends from the rectum through the sigmoid and descending colon in the upper-left abdomen. This type causes stomach pain and cramping on the left side, bloody diarrhea and weight loss.
Pancolitis: This type causes inflammation of the entire colon that causes stomach pain and cramping, bloody diarrhea, significant weight loss and fatigue.
Proctosigmoiditis: With this type, inflammation is in the rectum and lower area of the colon, causing stomach pain and cramping, bloody diarrhea and trouble moving your bowels despite the urge to go.
Ulcerative proctitis: This is the mildest form of ulcerative colitis. Inflammation is in the rectal area and causes rectal pain and bleeding and an urgent feeling to move your bowels.

Conditions related to ulcerative colitis

Ulcerative colitis may also cause arthritis, inflammation of the eye, liver disease and osteoporosis. Scientists believe these complications may be the result of inflammation triggered by the immune system.

Diagnosing ulcerative colitis

First, you’ll meet with your doctor for a physical exam. You’ll talk about your possible ulcerative colitis symptoms, and then your doctor may order tests such as:

Blood tests
Fecal occult blood test (shows if you have blood in your stool)
Sigmoidoscopy to examine the lower colon and rectum. A flexible tube is inserted in the anus to see inside the digestive system
Colonoscopy to see inside the colon. A flexible tube is inserted into the anus.
Capsule endoscopy to see images of the inside of the digestive tract. For this test, you swallow a capsule that contains a tiny camera that records video of your digestive tract.
MRI or CT scan
Double-contrast barium enema X-ray to show the rectum, colon and part of the intestine on X-rays. An enema coats the lining of the bowls with a dye (barium) so it shows on an X-ray.
Double balloon endoscopy to see from the esophagus to the colon. An endoscope (long tube) is inserted down the throat.

Ulcerative colitis treatment

If you’re diagnosed with ulcerative colitis, your Advocate care team will help create the best treatment plan for you. If none of these treatments help, you might need surgery. About 30% of people with ulcerative colitis will need surgery at some point.

Antibiotics
Anti-diarrheal drugs
Anti-inflammatory drugs
Biologic drugs
Dietary changes
Immune system suppressor drugs
Iron supplements
Pain-relieving drugs
Regular exercise

Make nutrition a priority

People with ulcerative colitis experience problems with properly digesting food and absorbing nutrients. Also, certain foods can aggravate ulcerative colitis symptoms, especially during flare-ups.

It’s important to minimize your risk of malnutrition and eat enough nutritious calories to keep you healthy. Your doctor may recommend working with a dietitian to help you choose the best foods for you.

Dietary recommendations for ulcerative colitis include limiting fiber, eating more low-fat foods, limiting dairy products such as cow’s milk, butter and cheese, and avoiding spicy foods, alcohol and caffeine. It’s best to eat several small meals during the day and drink lots of fluids to stay hydrated.