Ulcerative Colitis

This type of inflammatory bowel disease occurs in the rectum and affects the colon as well. Ulcerative colitis typically starts in the rectal area and may spread to involve the entire large intestine over time.


The cause is unknown, but ulcerative colitis is often linked to problems with the immune system. However, it is not clear whether immune problems cause this illness. Although stress and certain foods can trigger symptoms, they do not cause ulcerative colitis.

Risk Factors

Ulcerative colitis may affect any age group, although there are peaks between ages 15 and 30, and then again between ages 50 and 70. Other risk factors include:

  • Family history of ulcerative colitis
  • Jewish ancestry


  • Abdominal pain and cramping, abdominal sounds (gurgling/splashing)
  • Irregular stools (blood and pus in stools or diarrhea)
  • Rectal pain (tenesmus)
  • Weight loss
  • Fever
  • Slowed growth in children

Diagnostic Tests

A colonoscopy with a biopsy is generally used to diagnose ulcerative colitis. Since ulcerative colitis increases the risk of colon cancer, colonoscopies are also used to screen people for colon cancer. If you have this condition, you should get a colonoscopy 8 to 12 years after being diagnosed. You should then have a follow-up colonoscopy every 1 to 2 years.

Other tests that may be done as well, including:

  • Barium enema
  • Complete blood count (CBC)
  • C-reactive protein (CRP)
  • Sedimentation rate (ESR)


Treatment is used to control acute attacks, prevent repeated attacks and help the colon heal. These goals can be achieved through lifestyle changes, such as:

  • Eating small amounts of food throughout the day.
  • Drinking plenty of water (drink small amounts throughout the day).
  • Avoiding high-fiber foods (bran, beans, nuts, seeds, and popcorn).
  • Avoiding fatty, greasy or fried foods and sauces (butter, margarine, and heavy cream).
  • Limiting milking products if you are lactose intolerant.
  • Managing stress

The following medications may be used to decrease the number of attacks:

  • 5-aminosalicylates to help control moderate symptoms
  • Immunomodulators
  • Corticosteroids
  • Infliximab (Remicade) or other biological treatments, if you do not respond to other medications

Surgery to remove the colon will cure ulcerative colitis and removes the threat of colon cancer. Surgery is usually recommended for patients who have:

  • Colitis that does not respond to complete medical therapy
  • Changes in the lining of the colon that are thought to be precancerous
  • Serious complications such as rupture (perforation) of the colon, severe bleeding (hemorrhage), or toxic megacolon