Skip directly to content

Ulcerative Colitis

Text Increase:
Text Increase Normal
Text Increase Large
Text Increase Largest

Ulcerative colitis is an inflammatory bowel disease (IBD) that causes long-lasting inflammation in part of your digestive tract, usually the innermost lining of your large intestine and rectum. Ulcerative colitis can be debilitating and sometimes can lead to life-threatening complications.


Because ulcerative colitis is a chronic condition, symptoms usually develop over time, rather than suddenly.

Ulcerative colitis symptoms can vary, depending on the severity of inflammation and where it occurs. Doctors often classify ulcerative colitis according to its location.

  • Ulcerative proctitis tends to be the mildest. Inflammation is confined to the area closest to the anus (rectum). Rectal bleeding may be the only sign of the disease. Others may have rectal pain and a feeling of urgency.
  • Proctosigmoiditis involves the rectum and the lower end of the colon, known as the sigmoid colon. Common symptoms include bloody diarrhea, abdominal cramps and pain, and an inability to move the bowels.
  • Left-sided colitis extends from the rectum up through the sigmoid and descending colon, which are located in the upper left part of the abdomen. Signs and symptoms include bloody diarrhea, abdominal cramping and pain on the left side, and unintended weight loss.
  • Pancolitis often affects the entire colon. Symptoms include bouts of bloody diarrhea that may be severe, abdominal cramps and pain, fatigue, and significant weight loss.
  • Fulminant colitis is rare and life-threatening. It causes severe pain, profuse diarrhea and, sometimes, dehydration and shock.

Causes and Risk Factors

The precise cause of ulcerative colitis is unknown, however, current thinking focuses on the following possibilities:

  • Immune system response triggered by an infection.
  • Heredity

Ulcerative colitis affects about the same number of women and men, but there are known risk factors that may include:

  • Age. Ulcerative colitis usually begins before the age of 30. But, it can occur at any age, and some people may not develop the disease until their 50s or 60s.
  • Race or ethnicity. Although whites have the highest risk of the disease, it can occur in any race. If you're of Ashkenazi Jewish descent, your risk is even higher.

Diagnostic Tests

Your doctor will likely diagnose ulcerative colitis only after ruling out other possible causes for your signs and symptoms, including Crohn's disease, ischemic colitis, infection, irritable bowel syndrome (IBS), and diverticulitis and colon cancer. To help confirm a diagnosis of ulcerative colitis, you may have one or more of the following tests and procedures:

  • Blood tests to look for the presence of certain antibodies can sometimes help diagnose which type of inflammatory bowel disease you have.
  • Stool sample to look for blood, bacteria, parasites, and bowel infection.
  • Colonoscopy to view your entire colon and collect a small samples of tissue for laboratory analysis
  • Flexible sigmoidoscopy to examine the sigmoid, the last portion of your colon.
  • Barium enema to evaluate your entire large intestine with an X-ray.

A computerized tomography (CT) scan of your abdomen or pelvis may be performed if your doctor suspects a complication from ulcerative colitis or inflammation of the small intestine that might suggest Crohn's disease. A CT scan may also reveal how much of the colon is inflamed.

Treatment and Procedures

There's no known cure for ulcerative colitis, but therapies are available that may dramatically reduce the signs and symptoms of ulcerative colitis and even long-term remission.

Ulcerative colitis treatment usually involves either drug therapy or surgery.

  • Anti-inflammatory drugs to reduce inflammation
  • Immune system suppressors to reduce inflammation targeting your immune system rather than treating inflammation itself
  • Antibiotics
  • Anti-diarrheals
  • Pain relievers
  • Iron supplements if you have chronic intestinal bleeding
  • Surgery to eliminate ulcerative colitis usually by removing your entire colon and rectum

Your health is our greatest concern. Please contact the Center for Colon & Rectal Surgery at 407.303.2615for a private consultation today.