Ulcerative Colitis

What is ulcerative colitis?

Ulcerative colitis (say “ul-sir-uh-tiv cole-eye-tiss”) is an inflammatory bowel disease (IBD) that causes your colon (a part of your large intestine) to become red and swollen. The redness and swelling can last for a few weeks or for several months. Symptoms may come and go for up to a year. These occurrences are called flare-ups.

What causes ulcerative colitis?

No one knows for sure what causes ulcerative colitis. Some doctors think it may happen when your body overreacts to normal bacteria in your digestive system. Ulcerative colitis also seems to be hereditary. This means it runs in families.

What are the symptoms of ulcerative colitis?

Symptoms of ulcerative colitis vary depending on how severe your case is and what section of your large intestine is affected. Symptoms often include the following:
  • Diarrhea
  • Blood in the stool
  • Abdominal cramping and pain
  • Pain in the rectum
  • Unintended weight loss
  • Fatigue
  • A strong feeling that you need to have a bowel movement, but not being able to do so (called tenesmus)
You may have diarrhea over a period of weeks or months. The diarrhea may have blood in it. Some people have abdominal pain. The diarrhea and abdominal pain tend to come and go.

How is ulcerative colitis diagnosed?

Your doctor will ask you about your symptoms and your medical history. Your doctor will want to know if anyone else in your family has ulcerative colitis or an IBD. He or she may run tests on a sample of your stool and a sample of your blood. These tests can rule out other infections and check for IBDs, including ulcerative colitis. Your doctor may also look inside your colon with a special long, flexible, lighted tube. This test is called a colonoscopy.

How is ulcerative colitis treated?

There are many medicines available to treat the redness and swelling that occurs with ulcerative colitis. These medicines may be given in one of the following ways:
  • Orally (by mouth)
  • As an enema (an injection of liquid through the rectum)
  • As a suppository (a capsule of medicine that is inserted into the rectum and absorbed by the body)
  • Intravenously (into a vein)
You should check with your doctor before taking any over-the-counter medicines for pain or diarrhea.

If medicine for ulcerative colitis doesn’t help, you may need surgery. Between 25 percent and 40 percent of people who have ulcerative colitis eventually need surgery.

Will having ulcerative colitis affect my diet?

Certain foods and beverages can make the symptoms of ulcerative colitis worse. These may include the following:
  • Dairy products
  • High-fiber foods (such as raw fruits and vegetables)
  • Alcohol
  • Caffeine
  • Carbonated beverages
You may find that eating smaller meals more frequently throughout the day may help your ulcerative colitis. For example, try eating 5 small meals each day rather than 3 large meals. Drink plenty of liquids, but avoid caffeinated, carbonated and alcoholic beverages.

What else can I do?

Stress can make the symptoms of ulcerative colitis worse. Learn to manage your stress. Exercise regularly. When you are feeling overwhelmed, take a few deep breaths. Take time each day to do something relaxing that you enjoy, such as visiting with friends or reading a book.

If you have ulcerative colitis, you are at an increased risk of colon cancer. Talk to your doctor about whether regular screening for colon cancer is right for you.

More Information

For more information talk to your doctor.


Written by familydoctor.org editorial staff.

Ulcerative Colitis: Diagnosis and Treatment by Robert C. Langan, MD, Patricia B. Gotsch, MD, Michael A. Krafczyk, MD, and David D. Skillinge, DO (American Family Physician November 1, 2007, http://www.aafp.org/afp/20071101/1323.html)

Created: 10/09