Ulcerative Colitis

Ulcerative colitis is a disease that causes inflammation (painful swelling) and sores (ulcers) in the top layers of the lining of the large intestine. The inflammation usually occurs in the rectum and lower part of the colon (large intestine), although it may affect the entire organ. Ulcerative colitis may also be called colitis, ileitis or proctitis.

This disease is often difficult to diagnose because symptoms are very similar to and Crohn's disease.


About half of all patients have mild symptoms, including:

  • Abdominal pain and bloody diarrhea (most common symptoms)
  • Fatigue
  • Weight loss
  • Loss of appetite
  • Rectal bleeding
  • Loss of body fluids and nutrients

Other medical problems that crop up as a result of ulcerative colitis include arthritis, eye inflammation, liver disease, osteoporosis (loss of bone mass), skin rashes, anemia and kidney stones. These conditions are usually mild and go away when the colitis is treated.

Causes and Risk Factors

Affecting men and women equally, ulcerative colitis most often occurs in people 15 to 40 years of age. As with other conditions, ulcerative colitis has no known cause. The disease appears to run in some families. There is also some evidence that the body's immune (disease-fighting) system reacts to a virus or bacteria by causing ongoing inflammation in the intestinal wall. However, this has not been proven.

Stress does not cause ulcerative colitis nor do certain foods or food products, but these factors may set off symptoms in some people.

About five percent of people with ulcerative colitis develop colon cancer. The risk increases with the duration of the disease and how much of the colon is involved.


IBD specialists first perform a complete physical exam and then a number of tests to help determine whether ulcerative colitis is present. Blood tests check for anemia and high white blood count - conditions that can indicate bleeding or inflammation somewhere in the body. A sample of the patient's stool can also provide clues of bleeding or infection in the colon or rectum.

To see inside the colon and rectum, the doctor may perform a colonoscopy. An instrument called an endoscope is inserted into the anus. The long, flexible lighted tube connects to a computer screen and reveals any swelling, bleeding or ulcers on the colon wall. During this procedure, the doctor may also take a small sample of tissue to study under the microscope (biopsy).

A barium enema X-ray of the colon can shed more light on the patient's condition. For this procedure, the colon is filled with barium, a chalky white solution. The barium shows up on X-ray film to allow the doctor a clear view of and any problems on the colon.


Our team of IBD doctors design treatment plans for ulcerative colitis sufferers based on how severe the case is. Patients experience the condition differently, so treatment is adjusted for each individual. Emotional and psychological support is also an important part of any treatment plan.

Many patients have months or even years when the condition disappears. Unfortunately, most symptoms eventually come back. No one can predict when or for how long. A person with ulcerative colitis may need frequent checkups and regular medical care for some time.

Among the strategies used by IBD specialists are:

Patients are encouraged to consider all factors (needs, personal lifestyle and expectations) before making the decision to go ahead with surgical options.