Table of ContentsView AllTable of ContentsWhat Happens in UCPrevalenceSymptomsDiagnosisTreatmentColon Cancer and UCFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Happens in UC
Prevalence
Symptoms
Diagnosis
Treatment
Colon Cancer and UC
Frequently Asked Questions
Ulcerative colitis(UC) is a chronic condition that causes inflammation in the colon and can cause other complications throughout the body. It is aninflammatory bowel diseases (IBD), a category that also includesCrohn’s diseaseandindeterminate colitis.
The forms of IBD are sometimes confused for one anotherbecause the symptoms are similar. They are, however, different in the ways they affect the body and, in some cases, how they are treated.
This article will discuss what happens in the body when ulcerative colitis develops, how common the condition is, and its symptoms, diagnostic process, and treatment.
Verywell / Jessica Olah
What Happens During Ulcerative Colitis
The cause ofulcerative colitis, which is called pathophysiology, is not well understood. It’s thought that it may be connected to something causing the bacteria and other microbes that normally live in the colon to be out of balance, leading to an immune response and inflammation.
However, there is research underway that has started to uncover some of the reasons why people might develop the disease, including the following.
Genetic Predisposition
One of the factors involved in ulcerative colitis is that it does run in families. However, it’s not as simple as being passed down from parent to child. Most people with UC don’t have a family member who has the disease. However, they often have family members with autoimmune conditions.
So far, more than 200 genes have been found to be involved in the development of IBDs. This has led scientists to believe that several factors can cause ulcerative colitis to develop.
Immune Response
One of the factors involved in developing IBD is a problem with the immune system thatcauses the immune system to attack the colon. The attack leads to inflammation in the lining of the colon. This can also lead to inflammation in other areas of the body, including the skin, eyes, liver, and joints.
Environmental Factors
It’s thought that there are certain triggers in the environment that may lead to the development of IBD. These seem to be different based on geography.
Some of the factors that have been identified include cigarette smoking, a history of gastroenteritis (sometimes called the stomach flu), and certain drugs (includingoral contraceptives, hormone replacement therapy, andnonsteroidal anti-inflammatory drugs, or NSAIDs).
Inflammation of the ColonThe most prominent sign of ulcerative colitis is inflammation in the colon. Inflammation causes the formation of ulcers in the lining of thecolon. This can lead to symptoms of diarrhea, bloody stools, pain, and an urgency to go to the bathroom.
Inflammation of the Colon
The most prominent sign of ulcerative colitis is inflammation in the colon. Inflammation causes the formation of ulcers in the lining of thecolon. This can lead to symptoms of diarrhea, bloody stools, pain, and an urgency to go to the bathroom.
How Common Ulcerative Colitis Is
Ulcerative colitis is a common disease. In fact, cases are increasing throughout the world. The prevalence per every 100,000 people is estimated to be:
The signs and symptoms of ulcerative colitis may vary slightly from person to person. However, the most common symptoms include:
The diagnosis of ulcerative colitis is made after your healthcare provider looks into your symptoms and performs tests to find out what is causing them. Endoscopic tests that use a lighted, flexible tube inserted into the body (such assigmoidoscopyorcolonoscopy), biopsies (tissue taken from the lining of the colon to be tested in a lab), and ruling out other diseases to explain your symptoms all help make the diagnosis.
The treatments for ulcerative colitis can include medications, surgery, complementary therapies, and diet and lifestyle changes.
Medications
The medications used to treat ulcerative colitis will depend on several factors, including how serious the disease is, the age of the patient, and doctor and patient preferences. Some of the classes of medications used are:
Surgery
Surgery may be used to treat ulcerative colitis. Removing the colon (colectomy) is done for a variety of reasons, including if there’s a risk of colon cancer or other complications such as a perforation (hole) in the large intestine. Having a poor quality of life due to symptoms is another reason for having surgery.
If a total colectomy is performed, it is considered curative for ulcerative colitis.
After acolectomy, another way for stool to leave the body must be created. That means adding either an ileostomy or anileal pouch-anal anastomosis (IPAA).
In anileostomy, astomais created in the abdomen for stool to leave the body, over which an appliance is worn. In an IPAA (commonly called a J-pouch), the small intestine is connected to the anus and stool leaves the body through the bottom.
Complementary Therapies
People with ulcerative colitis often try nondrug treatments to manage their disease. Some that may help people who live with ulcerative colitis manage their disease includeacupuncture, mind-body interventions (mindfulness, meditation, relaxation training), andyoga.
Always check with your healthcare provider about using supplements to ensure they don’t interfere with other therapies.
Diet and Lifestyle
Sufficient data on diet in ulcerative colitis are still lacking. However, one 2021 study in Crohn’s disease has shown that both thespecific carbohydrate diet(a restrictive diet that is free of grains and processed foods) and the Mediterranean diet (made up of healthy fats, whole grains, plant-based foods, and lean poultry or fatty fish, such as salmon and albacore tuna) were helpful in reducing symptoms.
Colon Cancer and Ulcerative Colitis
Summary
Ulcerative colitis is a condition that causes inflammation (swelling and redness) in the colon and sometimes in other areas of the body. It’s not known what causes it to start, but it’s thought that both genetics and other factors cause the good microbes that live in the colon to get out of balance.
There are many drugs and complementary treatments that can help people with ulcerative colitis keep symptoms under control and have a good quality of life.
A Word From Verywell
What causes ulcerative colitis is still not known. However, it does seem to be a complex interaction of genetics and environmental factors. Stress is not a cause of ulcerative colitis, though it can make symptoms worse. If you have ulcerative colitis, you have many good choices for disease management and can expect to live a full, normal life.
Frequently Asked QuestionsIrritable bowel disease (IBD) is a collection of diseases that affect the immune system. They cause inflammation in the digestive system. In some people, inflammation may occur in other parts of the body, such as the eyes, skin, and joints.Crohn’s disease and ulcerative colitis are both forms of IBD. The main difference between the two is that ulcerative colitis affects the colon and Crohn’s disease can affect any part of the digestive system. In addition, blood in the stool is less common and abdominal pain is more common in Crohn’s disease than in ulcerative colitis.There are probably many causes of ulcerative colitis. But it’s thought that they may all stem from an imbalance in the microbiome (microbes that can be both helpful and potentially harmful) of the colon. Something causes the bacteria and other microbes (such as viruses and fungi) that normally live there to be out of balance.The various forms of IBD are probably better described as immune-mediated diseases rather than autoimmune diseases. This is because no autoantibodies have been found to be connected to IBD.Because every person with IBD experiences the disease differently, there is no one diet that is recommended for all people who live with the disease. In addition, there hasn’t been much study to recommend any one diet over another.Dietitians often recommend a modified Mediterranean diet for their patients who are in remission (without symptoms). However, patients should always work with their medical team on diet to avoid vitamin deficiencies and malnutrition.
Irritable bowel disease (IBD) is a collection of diseases that affect the immune system. They cause inflammation in the digestive system. In some people, inflammation may occur in other parts of the body, such as the eyes, skin, and joints.
Crohn’s disease and ulcerative colitis are both forms of IBD. The main difference between the two is that ulcerative colitis affects the colon and Crohn’s disease can affect any part of the digestive system. In addition, blood in the stool is less common and abdominal pain is more common in Crohn’s disease than in ulcerative colitis.
There are probably many causes of ulcerative colitis. But it’s thought that they may all stem from an imbalance in the microbiome (microbes that can be both helpful and potentially harmful) of the colon. Something causes the bacteria and other microbes (such as viruses and fungi) that normally live there to be out of balance.
The various forms of IBD are probably better described as immune-mediated diseases rather than autoimmune diseases. This is because no autoantibodies have been found to be connected to IBD.
Because every person with IBD experiences the disease differently, there is no one diet that is recommended for all people who live with the disease. In addition, there hasn’t been much study to recommend any one diet over another.Dietitians often recommend a modified Mediterranean diet for their patients who are in remission (without symptoms). However, patients should always work with their medical team on diet to avoid vitamin deficiencies and malnutrition.
Because every person with IBD experiences the disease differently, there is no one diet that is recommended for all people who live with the disease. In addition, there hasn’t been much study to recommend any one diet over another.
Dietitians often recommend a modified Mediterranean diet for their patients who are in remission (without symptoms). However, patients should always work with their medical team on diet to avoid vitamin deficiencies and malnutrition.
7 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.Guan Q.A comprehensive review and update on the pathogenesis of inflammatory bowel disease.Journal of Immunology Research. 2019;2019:1-16. doi:10.1155/2019/7247238Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel JF.Ulcerative colitis.Lancet. 2017;389(10080):1756-1770. doi:10.1016/S0140-6736(16)32126-2.Gajendran M, Loganathan P, Jimenez G, et al.A comprehensive review and update on ulcerative colitis.Dis Mon.2019;65(12):100851. doi:10.1016/j.disamonth.2019.02.004Gallo 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.2018.05.017Langhorst J, Wulfert H, Lauche R, et al.Systematic review of complementary and alternative medicine treatments in inflammatory bowel diseases.J Crohns Colitis.2015;9(1):86-106. doi:10.1093/ecco-jcc/jju007Lewis JD, Sandler RS, Brotherton C, et al.A randomized trial comparing the specific carbohydrate diet to a mediterranean diet in adults with Crohn’s disease.Gastroenterology. 2021;161(3):837-852.e9. doi:10.1053/j.gastro.2021.05.047Choi CR, Bakir IA, Hart AL, Graham TA.Clonal evolution of colorectal cancer in IBD.Nat Rev Gastroenterol Hepatol.2017;14(4):218-229. doi:10.1038/nrgastro.2017.1
7 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.Guan Q.A comprehensive review and update on the pathogenesis of inflammatory bowel disease.Journal of Immunology Research. 2019;2019:1-16. doi:10.1155/2019/7247238Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel JF.Ulcerative colitis.Lancet. 2017;389(10080):1756-1770. doi:10.1016/S0140-6736(16)32126-2.Gajendran M, Loganathan P, Jimenez G, et al.A comprehensive review and update on ulcerative colitis.Dis Mon.2019;65(12):100851. doi:10.1016/j.disamonth.2019.02.004Gallo 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.2018.05.017Langhorst J, Wulfert H, Lauche R, et al.Systematic review of complementary and alternative medicine treatments in inflammatory bowel diseases.J Crohns Colitis.2015;9(1):86-106. doi:10.1093/ecco-jcc/jju007Lewis JD, Sandler RS, Brotherton C, et al.A randomized trial comparing the specific carbohydrate diet to a mediterranean diet in adults with Crohn’s disease.Gastroenterology. 2021;161(3):837-852.e9. doi:10.1053/j.gastro.2021.05.047Choi CR, Bakir IA, Hart AL, Graham TA.Clonal evolution of colorectal cancer in IBD.Nat Rev Gastroenterol Hepatol.2017;14(4):218-229. doi:10.1038/nrgastro.2017.1
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.
Guan Q.A comprehensive review and update on the pathogenesis of inflammatory bowel disease.Journal of Immunology Research. 2019;2019:1-16. doi:10.1155/2019/7247238Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel JF.Ulcerative colitis.Lancet. 2017;389(10080):1756-1770. doi:10.1016/S0140-6736(16)32126-2.Gajendran M, Loganathan P, Jimenez G, et al.A comprehensive review and update on ulcerative colitis.Dis Mon.2019;65(12):100851. doi:10.1016/j.disamonth.2019.02.004Gallo 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.2018.05.017Langhorst J, Wulfert H, Lauche R, et al.Systematic review of complementary and alternative medicine treatments in inflammatory bowel diseases.J Crohns Colitis.2015;9(1):86-106. doi:10.1093/ecco-jcc/jju007Lewis JD, Sandler RS, Brotherton C, et al.A randomized trial comparing the specific carbohydrate diet to a mediterranean diet in adults with Crohn’s disease.Gastroenterology. 2021;161(3):837-852.e9. doi:10.1053/j.gastro.2021.05.047Choi CR, Bakir IA, Hart AL, Graham TA.Clonal evolution of colorectal cancer in IBD.Nat Rev Gastroenterol Hepatol.2017;14(4):218-229. doi:10.1038/nrgastro.2017.1
Guan Q.A comprehensive review and update on the pathogenesis of inflammatory bowel disease.Journal of Immunology Research. 2019;2019:1-16. doi:10.1155/2019/7247238
Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel JF.Ulcerative colitis.Lancet. 2017;389(10080):1756-1770. doi:10.1016/S0140-6736(16)32126-2.
Gajendran M, Loganathan P, Jimenez G, et al.A comprehensive review and update on ulcerative colitis.Dis Mon.2019;65(12):100851. doi:10.1016/j.disamonth.2019.02.004
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
Langhorst J, Wulfert H, Lauche R, et al.Systematic review of complementary and alternative medicine treatments in inflammatory bowel diseases.J Crohns Colitis.2015;9(1):86-106. doi:10.1093/ecco-jcc/jju007
Lewis JD, Sandler RS, Brotherton C, et al.A randomized trial comparing the specific carbohydrate diet to a mediterranean diet in adults with Crohn’s disease.Gastroenterology. 2021;161(3):837-852.e9. doi:10.1053/j.gastro.2021.05.047
Choi CR, Bakir IA, Hart AL, Graham TA.Clonal evolution of colorectal cancer in IBD.Nat Rev Gastroenterol Hepatol.2017;14(4):218-229. doi:10.1038/nrgastro.2017.1
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