Table of ContentsView AllTable of ContentsIs It Autoimmune?Is the Immune System Compromised?COVID-19 RisksManaging Symptoms
Table of ContentsView All
View All
Table of Contents
Is It Autoimmune?
Is the Immune System Compromised?
COVID-19 Risks
Managing Symptoms
What causes this disorder is not completely understood. It is thought that some people may have genes that predispose them to developing the condition and that one or more environmental triggers begin the disease process.
This article discusses how the immune system’s involvement in developing ulcerative colitis differs from the strict definition of an autoimmune disease, the effects of the condition and its impact on immune function, and how to manage symptoms of ulcerative colitis.
Maksym Belchenko / Getty Images
Is Ulcerative Colitis an Autoimmune Disease?
Ulcerative colitis, andIBD in general, are thought to involve a problem with the immune system. The immune system defends the body from invaders, such as viruses and bacteria. Sometimes, the immune response can’t tell the difference between an actual foreign invader and healthy tissue.
A disease or condition is called autoimmune when there is a presence ofantibodies(specific immune proteins). These antibodies target normal, healthy tissue and cause inflammation.
Autoimmune diseasescan result from the creation of a variety of different types of antibodies. Some conditions are diagnosed with the use of a laboratory test (such as a blood test) that finds these antibodies.
Some types of antibodies are found in people with ulcerative colitis and its companion condition, Crohn’s disease. However, not every person who has a form of IBD has these antibodies. There isn’t one specific type of antibody that’s been found in all people who live with ulcerative colitis.
For that reason, there may be other terms that fit ulcerative colitis better than “autoimmune.” There may be an autoimmune component, but there is also more to the story of the development of IBD.
Some experts are now calling IBD an “immune-mediated” or “autoinflammatory” disease. Ulcerative colitis might be called animmune-mediated inflammatory disease with an autoimmune component.
Does Ulcerative Colitis Compromise the Immune System?
Ulcerative colitis can affect body systems outside of the digestive tract. People with active and especially severe ulcerative colitis may become really unwell and evenmalnourished. Being in poor physical condition overall could leave people open to infections.
Because ulcerative colitis is linked to an overactive immune response, it may be treated with medications that affect the immune system. IBD medications may target specific parts of the immune system, causing it to slow down its activity.
The immune system is not like a switch that is turned on or off; it is far more complicated than that. Medications used to treat IBD, such as biologics, steroids, or immunomodulators, turn down parts of the immune system in specific ways. In some cases, this can lead to a person’s immune system being less able to fight off infection with viruses or bacteria.
Risks and Complications of Untreated Ulcerative Colitis
Is There a Higher Risk of Getting COVID-19 With Ulcerative Colitis?
People who live with ulcerative colitis do not have a greater risk of becoming infected with the virus that causes COVID-19 than the general population.Even for those taking a medication that affects the immune system, there does not appear to be a greater risk.
People with ulcerative colitis can also live with other conditions. The following comorbid (co-occurring) conditions mayincrease the risk of a poor outcome from COVID-19:
How to Manage Symptoms of Ulcerative Colitis
It’s important to treat ulcerative colitis in order to avoid complications. Ulcerative colitis needs to be managed throughout a person’s lifetime. This often means combining medications and lifestyle changes. In a minority of cases, managing the condition is done through surgery.
Medications and Therapies
The types of medications that may be used to treat ulcerative colitis include:
Lifestyle Changes and Self-Care
Along with medications, changes in lifestyle are usually used to manage symptoms of ulcerative colitis. These habits may not help directly with inflammation, but they can improve quality of life and reduce symptoms.
Ulcerative colitis affects everyone differently, but lifestyle habits that can help everyone include:
Diet and Nutrition Tips
Diet can be an important part of managing ulcerative colitis. However, no single diet alone is prescribed for all people with this condition.
Instead many people instead find the best diet that works for them. This could be a combination of understanding what has worked for others, what a healthcare provider recommends, and what the research has shown.
Surgical Options
Surgery is another treatment option for severe or complicated ulcerative colitis. For some people, surgery may be needed because the symptoms are not controlled and are causing serious complications. Others may choose surgery because their quality of life is poor.
People with ulcerative colitis have some options when it comes to surgery to manage the condition.
Colectomy with ileal pouch-anal anastomosis (IPAA): This is the most commonly used surgery to treat ulcerative colitis. It is also known asJ-pouch surgery.
The colon and most or all of the rectum are removed. The last section of thesmall intestineis folded on itself to make the shape of a “J.” This serves as a rectum, and stool is eliminated from the bottom through the anus. This surgery may be done in two or three stages.
Colectomy with ileostomy: In this surgery, the colon is removed. An opening is created in the abdomen, and a little part of the small intestine is brought through it and outside the body. Stool leaves the body through this opening, which is called a stoma.
An appliance is worn over the stoma to collect the stool. It is emptied several times a day. The rectum and anus are often left in place. However, if ulcerative colitis continues to cause disease there, they might also be removed in a surgery called a proctectomy.
Continent ostomy: This surgery is specialized and is used less often than others. An internal reservoir is created from the small intestine, but it is not connected to the anus. Instead, it is accessed through what’s called a nipple valve made from part of the ileum in the abdomen.
Stool is eliminated from the body when a catheter is placed into the nipple. There’s usually no need for an external appliance on the abdomen, but people may place a bandage over the nipple.
How Ulcerative Colitis Is Treated
A Word From VerywellIf you have ulcerative colitis, it is important that you follow your gastroenterologist’s recommendations regarding medications, diet, lifestyle, and other treatment options for the best long-term results.—JAY N. YEPURI, MD, MEDICAL EXPERT BOARD
A Word From Verywell
If you have ulcerative colitis, it is important that you follow your gastroenterologist’s recommendations regarding medications, diet, lifestyle, and other treatment options for the best long-term results.—JAY N. YEPURI, MD, MEDICAL EXPERT BOARD
If you have ulcerative colitis, it is important that you follow your gastroenterologist’s recommendations regarding medications, diet, lifestyle, and other treatment options for the best long-term results.
—JAY N. YEPURI, MD, MEDICAL EXPERT BOARD
Summary
Ulcerative colitis might be treated with medications that slow down the immune response, lifestyle and diet changes, and surgery. There’s currently no known cure for ulcerative colitis.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mitsuyama K, Niwa M, Takedatsu H, et al.Antibody markers in the diagnosis of inflammatory bowel disease.World J Gastroenterol. 2016;22:1304-1310. doi:10.3748/wjg.v22.i3.1304.García MJ, Pascual M, Del Pozo C, et al.Impact of immune-mediated diseases in inflammatory bowel disease and implications in therapeutic approach.Sci Rep. 2020;10(1):10731. doi:10.1038/s41598-020-67710-2Kirchgesner J, Lemaitre M, Carrat F, Zureik M, Carbonnel F, Dray-Spira R.Risk of serious and opportunistic infections associated with treatment of inflammatory bowel diseases.Gastroenterology. 2018;155(2):337-346.e10. doi:10.1053/j.gastro.2018.04.012Solitano V, D’Amico F, Zacharopoulou E, Peyrin-Biroulet L, Danese S.Early intervention in ulcerative colitis: ready for prime time?J Clin Med. 2020;9:2646. doi:10.3390/jcm9082646Siegel CA, Melmed GY, McGovern DP, et al.SARS-CoV-2 vaccination for patients with inflammatory bowel diseases: recommendations from an international consensus meeting.Gut. 2021;70:635-640. doi:10.1136/gutjnl-2020-324000Monteleone G, Ardizzone S.Are patients with inflammatory bowel disease at increased risk for COVID-19 infection?J Crohns Colitis. 2020;14:1334-1336. doi:10.1093/ecco-jcc/jjaa061Rubin DT, Abreu MT, Rai V, Siegel CA; International Organization for the Study of Inflammatory Bowel Disease.Management of patients with Crohn’s disease and ulcerative colitis during the coronavirus disease-2019 pandemic: results of an international meeting.Gastroenterology. 2020;159:6-13.e6. doi:10.1053/j.gastro.2020.04.002National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases.Underlying medical conditions associated with higher risk for severe COVID-19: information for healthcare professionals.Rubin DT, Ananthakrishnan AN, Siegel CA, et al.ACG Clinical Guideline: ulcerative colitis in adults.Am J Gastroenterol. 2019;114:384-413. doi:10.14309/ajg.0000000000000152Rozich JJ, Holmer A, Singh S.Effect of lifestyle factors on outcomes in patients with inflammatory bowel diseases.Am J Gastroenterol. 2020;115(6):832-840. doi:10.14309/ajg.0000000000000608Taft TH, Ballou S, Bedell A, Lincenberg D.Psychological considerations and interventions in inflammatory bowel disease patient care.Gastroenterol Clin North Am. 2017;46:847-858Olendzki B, Bucci V, Cawley C, et al.Dietary manipulation of the gut microbiome in inflammatory bowel disease patients: pilot study.Gut Microbes. 2022;14:2046244. doi:10.1080/19490976.2022.2046244Cox SR, Lindsay JO, Fromentin S, et al.Effects of low FODMAP diet on symptoms, fecal microbiome, and markers of inflammation in patients with quiescent inflammatory bowel disease in a randomized trial.Gastroenterology. 2020;158:176-188.e7. doi:10.1053/j.gastro.2019.09.024Gallo G, Kotze PG, Spinelli A.Surgery in ulcerative colitis: When? How?Best Pract Res Clin Gastroenterol. 2018;32-33:71-78. doi:10.1016/j.bpg.2018.05.017Kayal M, Rubin P, Bauer J, Waye JD.The Kock pouch in the 21st century (with videos).Gastrointest Endosc. 2020;92:184-189. doi:10.1016/j.gie.2020.02.031
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mitsuyama K, Niwa M, Takedatsu H, et al.Antibody markers in the diagnosis of inflammatory bowel disease.World J Gastroenterol. 2016;22:1304-1310. doi:10.3748/wjg.v22.i3.1304.García MJ, Pascual M, Del Pozo C, et al.Impact of immune-mediated diseases in inflammatory bowel disease and implications in therapeutic approach.Sci Rep. 2020;10(1):10731. doi:10.1038/s41598-020-67710-2Kirchgesner J, Lemaitre M, Carrat F, Zureik M, Carbonnel F, Dray-Spira R.Risk of serious and opportunistic infections associated with treatment of inflammatory bowel diseases.Gastroenterology. 2018;155(2):337-346.e10. doi:10.1053/j.gastro.2018.04.012Solitano V, D’Amico F, Zacharopoulou E, Peyrin-Biroulet L, Danese S.Early intervention in ulcerative colitis: ready for prime time?J Clin Med. 2020;9:2646. doi:10.3390/jcm9082646Siegel CA, Melmed GY, McGovern DP, et al.SARS-CoV-2 vaccination for patients with inflammatory bowel diseases: recommendations from an international consensus meeting.Gut. 2021;70:635-640. doi:10.1136/gutjnl-2020-324000Monteleone G, Ardizzone S.Are patients with inflammatory bowel disease at increased risk for COVID-19 infection?J Crohns Colitis. 2020;14:1334-1336. doi:10.1093/ecco-jcc/jjaa061Rubin DT, Abreu MT, Rai V, Siegel CA; International Organization for the Study of Inflammatory Bowel Disease.Management of patients with Crohn’s disease and ulcerative colitis during the coronavirus disease-2019 pandemic: results of an international meeting.Gastroenterology. 2020;159:6-13.e6. doi:10.1053/j.gastro.2020.04.002National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases.Underlying medical conditions associated with higher risk for severe COVID-19: information for healthcare professionals.Rubin DT, Ananthakrishnan AN, Siegel CA, et al.ACG Clinical Guideline: ulcerative colitis in adults.Am J Gastroenterol. 2019;114:384-413. doi:10.14309/ajg.0000000000000152Rozich JJ, Holmer A, Singh S.Effect of lifestyle factors on outcomes in patients with inflammatory bowel diseases.Am J Gastroenterol. 2020;115(6):832-840. doi:10.14309/ajg.0000000000000608Taft TH, Ballou S, Bedell A, Lincenberg D.Psychological considerations and interventions in inflammatory bowel disease patient care.Gastroenterol Clin North Am. 2017;46:847-858Olendzki B, Bucci V, Cawley C, et al.Dietary manipulation of the gut microbiome in inflammatory bowel disease patients: pilot study.Gut Microbes. 2022;14:2046244. doi:10.1080/19490976.2022.2046244Cox SR, Lindsay JO, Fromentin S, et al.Effects of low FODMAP diet on symptoms, fecal microbiome, and markers of inflammation in patients with quiescent inflammatory bowel disease in a randomized trial.Gastroenterology. 2020;158:176-188.e7. doi:10.1053/j.gastro.2019.09.024Gallo G, Kotze PG, Spinelli A.Surgery in ulcerative colitis: When? How?Best Pract Res Clin Gastroenterol. 2018;32-33:71-78. doi:10.1016/j.bpg.2018.05.017Kayal M, Rubin P, Bauer J, Waye JD.The Kock pouch in the 21st century (with videos).Gastrointest Endosc. 2020;92:184-189. doi:10.1016/j.gie.2020.02.031
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Mitsuyama K, Niwa M, Takedatsu H, et al.Antibody markers in the diagnosis of inflammatory bowel disease.World J Gastroenterol. 2016;22:1304-1310. doi:10.3748/wjg.v22.i3.1304.García MJ, Pascual M, Del Pozo C, et al.Impact of immune-mediated diseases in inflammatory bowel disease and implications in therapeutic approach.Sci Rep. 2020;10(1):10731. doi:10.1038/s41598-020-67710-2Kirchgesner J, Lemaitre M, Carrat F, Zureik M, Carbonnel F, Dray-Spira R.Risk of serious and opportunistic infections associated with treatment of inflammatory bowel diseases.Gastroenterology. 2018;155(2):337-346.e10. doi:10.1053/j.gastro.2018.04.012Solitano V, D’Amico F, Zacharopoulou E, Peyrin-Biroulet L, Danese S.Early intervention in ulcerative colitis: ready for prime time?J Clin Med. 2020;9:2646. doi:10.3390/jcm9082646Siegel CA, Melmed GY, McGovern DP, et al.SARS-CoV-2 vaccination for patients with inflammatory bowel diseases: recommendations from an international consensus meeting.Gut. 2021;70:635-640. doi:10.1136/gutjnl-2020-324000Monteleone G, Ardizzone S.Are patients with inflammatory bowel disease at increased risk for COVID-19 infection?J Crohns Colitis. 2020;14:1334-1336. doi:10.1093/ecco-jcc/jjaa061Rubin DT, Abreu MT, Rai V, Siegel CA; International Organization for the Study of Inflammatory Bowel Disease.Management of patients with Crohn’s disease and ulcerative colitis during the coronavirus disease-2019 pandemic: results of an international meeting.Gastroenterology. 2020;159:6-13.e6. doi:10.1053/j.gastro.2020.04.002National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases.Underlying medical conditions associated with higher risk for severe COVID-19: information for healthcare professionals.Rubin DT, Ananthakrishnan AN, Siegel CA, et al.ACG Clinical Guideline: ulcerative colitis in adults.Am J Gastroenterol. 2019;114:384-413. doi:10.14309/ajg.0000000000000152Rozich JJ, Holmer A, Singh S.Effect of lifestyle factors on outcomes in patients with inflammatory bowel diseases.Am J Gastroenterol. 2020;115(6):832-840. doi:10.14309/ajg.0000000000000608Taft TH, Ballou S, Bedell A, Lincenberg D.Psychological considerations and interventions in inflammatory bowel disease patient care.Gastroenterol Clin North Am. 2017;46:847-858Olendzki B, Bucci V, Cawley C, et al.Dietary manipulation of the gut microbiome in inflammatory bowel disease patients: pilot study.Gut Microbes. 2022;14:2046244. doi:10.1080/19490976.2022.2046244Cox SR, Lindsay JO, Fromentin S, et al.Effects of low FODMAP diet on symptoms, fecal microbiome, and markers of inflammation in patients with quiescent inflammatory bowel disease in a randomized trial.Gastroenterology. 2020;158:176-188.e7. doi:10.1053/j.gastro.2019.09.024Gallo G, Kotze PG, Spinelli A.Surgery in ulcerative colitis: When? How?Best Pract Res Clin Gastroenterol. 2018;32-33:71-78. doi:10.1016/j.bpg.2018.05.017Kayal M, Rubin P, Bauer J, Waye JD.The Kock pouch in the 21st century (with videos).Gastrointest Endosc. 2020;92:184-189. doi:10.1016/j.gie.2020.02.031
Mitsuyama K, Niwa M, Takedatsu H, et al.Antibody markers in the diagnosis of inflammatory bowel disease.World J Gastroenterol. 2016;22:1304-1310. doi:10.3748/wjg.v22.i3.1304.
García MJ, Pascual M, Del Pozo C, et al.Impact of immune-mediated diseases in inflammatory bowel disease and implications in therapeutic approach.Sci Rep. 2020;10(1):10731. doi:10.1038/s41598-020-67710-2
Kirchgesner J, Lemaitre M, Carrat F, Zureik M, Carbonnel F, Dray-Spira R.Risk of serious and opportunistic infections associated with treatment of inflammatory bowel diseases.Gastroenterology. 2018;155(2):337-346.e10. doi:10.1053/j.gastro.2018.04.012
Solitano V, D’Amico F, Zacharopoulou E, Peyrin-Biroulet L, Danese S.Early intervention in ulcerative colitis: ready for prime time?J Clin Med. 2020;9:2646. doi:10.3390/jcm9082646
Siegel CA, Melmed GY, McGovern DP, et al.SARS-CoV-2 vaccination for patients with inflammatory bowel diseases: recommendations from an international consensus meeting.Gut. 2021;70:635-640. doi:10.1136/gutjnl-2020-324000
Monteleone G, Ardizzone S.Are patients with inflammatory bowel disease at increased risk for COVID-19 infection?J Crohns Colitis. 2020;14:1334-1336. doi:10.1093/ecco-jcc/jjaa061
Rubin DT, Abreu MT, Rai V, Siegel CA; International Organization for the Study of Inflammatory Bowel Disease.Management of patients with Crohn’s disease and ulcerative colitis during the coronavirus disease-2019 pandemic: results of an international meeting.Gastroenterology. 2020;159:6-13.e6. doi:10.1053/j.gastro.2020.04.002
National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases.Underlying medical conditions associated with higher risk for severe COVID-19: information for healthcare professionals.
Rubin DT, Ananthakrishnan AN, Siegel CA, et al.ACG Clinical Guideline: ulcerative colitis in adults.Am J Gastroenterol. 2019;114:384-413. doi:10.14309/ajg.0000000000000152
Rozich JJ, Holmer A, Singh S.Effect of lifestyle factors on outcomes in patients with inflammatory bowel diseases.Am J Gastroenterol. 2020;115(6):832-840. doi:10.14309/ajg.0000000000000608
Taft TH, Ballou S, Bedell A, Lincenberg D.Psychological considerations and interventions in inflammatory bowel disease patient care.Gastroenterol Clin North Am. 2017;46:847-858
Olendzki B, Bucci V, Cawley C, et al.Dietary manipulation of the gut microbiome in inflammatory bowel disease patients: pilot study.Gut Microbes. 2022;14:2046244. doi:10.1080/19490976.2022.2046244
Cox SR, Lindsay JO, Fromentin S, et al.Effects of low FODMAP diet on symptoms, fecal microbiome, and markers of inflammation in patients with quiescent inflammatory bowel disease in a randomized trial.Gastroenterology. 2020;158:176-188.e7. doi:10.1053/j.gastro.2019.09.024
Gallo G, Kotze PG, Spinelli A.Surgery in ulcerative colitis: When? How?Best Pract Res Clin Gastroenterol. 2018;32-33:71-78. doi:10.1016/j.bpg.2018.05.017
Kayal M, Rubin P, Bauer J, Waye JD.The Kock pouch in the 21st century (with videos).Gastrointest Endosc. 2020;92:184-189. doi:10.1016/j.gie.2020.02.031
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