Ulcerative Colitis
(UC; Colitis, Ulcerative)
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
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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:
- Liver disease
- Kidney stones
- Osteoporosis
- Colon cancer
Diagnosis
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Testing may include:
- Blood tests
- Stool test
- Barium enema
- Flexible sigmoidoscopy
- Colonoscopy
- Biopsy
Treatment
Treatment options may include:
Dietary Changes
Your doctor may recommend that you avoid certain foods, such as:
- Dairy (due to lactose intolerance)
- Alcohol
- Red and processed meats
- Refined sugar
- Saturated fat
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