Definition

Ulcerative colitis (UC) is a type of severe, chronic inflammatory bowel disease (IBD), which causes:

  • Inflammation in the lining of the colon and rectum
  • Ulcers in the lining of the colon and rectum
  • Bleeding in the lining of the colon and rectum

Ulcerative Colitis

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Causes

The exact cause is unknown. A virus or bacteria may cause the immune system to overreact and damage the colon and rectum.

Risk Factors

Having a family member with IBD (includes UC and Crohn disease) may increase your risk of developing UC.

Symptoms

UC may cause:

  • Diarrhea
  • Abdominal cramps and pain
  • Rectal bleeding
  • Anemia
  • Weight loss
  • Fatigue, weakness
  • Nausea
  • Fever
  • Skin rashes
  • Arthritis
  • Eye inflammation, such as uveitis

Intestinal complications of UC may include:

  • Perforation
  • Fistula—abnormal passageway between 2 bodily structures
  • Obstruction
  • Excess bleeding
  • Toxic megacolon—a potentially life-threatening condition when the colon severely expands, which may result in reduced blood flow

Other complications of UC may include:

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Testing may include:

Treatment

Treatment options may include:

Dietary Changes

Your doctor may recommend that you avoid certain foods, such as:

Talk to your doctor or dietitian about what foods may work best for you.

Medications

There are a range of medicines that may be prescribed, such as:

  • Aminosalicylates
  • Steroid anti-inflammatory medications
  • Immune modifiers
  • Biological agents

Surgery

Surgery involves partial or complete removal of the colon. This may be necessary for:

  • An emergency, such as a perforation, excessive bleeding, or life-threatening infection
  • Long-term disease that does not respond to medications or other treatment
  • Colon cancer—includes confirmed diagnosis or suspicious tissue on examination
  • Lack of growth because of nutritional deficiencies (in children)

Surgery for UC is curative and reduces the risk of colon cancer.

Fecal Transplantation

Fecal transplantation may be used to treat UC.

Prevention

There are no current guidelines to prevent UC.

RESOURCES:

American Gastroenterological Society
http://www.gastro.org

Crohn's & Colitis Foundation
http://www.crohnscolitisfoundation.org

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
https://www.cag-acg.org

Crohn's and Colitis Canada
http://crohnsandcolitis.ca

REFERENCES:

D'Haens GR, Sartor RB, et al. Future directions in inflammatory bowel disease management. 2014;8(8):726-734.

Richman S, Schub T. Ulcerative colitis. EBSCO Nursing Reference Center website. Available at:http://www.ebscohost.com/nursing/products/nursing-reference-center. Updated August 2012. Accessed October 3, 2017.

Ulcerative colitis. EBSCO DynaMed website. Available at:http://www.dynamed.com/topics/dmp~AN~T114507/Ulcerative-colitis. Updated July 28, 2017. Accessed October 3, 2017.

Wedlake L, Slack N, et al. Fiber in the treatment and maintenance of inflammatory bowel disease: a systematic review of randomized controlled trials. Inflamm Bowel Dis. 2014;20(3):576-586.

What is ulcerative colitis? Crohn's & Colitis Foundation website. Available at: http://www.crohnscolitisfoundation.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis. Accessed October 3, 2017.

8/31/2015 DynaMed Systematic Literature Surveillance Updatehttp://www.dynamed.com/topics/dmp~AN~T114507/Ulcerative-colitis: Moayyedi P, Surette MG, et al. Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial. Gastroenterology. 2015;149(1):102-109.

Last reviewed September 2018 by EBSCO Medical Review Board Daus Mahnke, MD  Last Updated: 8/14/2020