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Ulcerative colitis

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 4 minutes read

Ulcerative colitis is a condition where there is inflammation of the large bowel and rectum (the last part of the bowel where poop is stored). This inflammation can lead to severe problems, including bowel lining ulcers. Those suffering complaints of tummy pain and diarrhea often notice blood and mucus mixed in the stool.

Weight loss can occur as vital nutrients aren't absorbed, and the body puts its efforts into the inflammation process. You may also have a mild fever and feel fatigued, to the extent it's hard to get on with your daily tasks.

Symptoms can range from mild to severe, and there can be long periods of being symptom-free between flare-ups. How often you're opening your bowels can be a good marker of how bad the symptoms are. If you are emptying your bowels more than six times a day, this is a serious flare of symptoms.

Ulcerative colitis is a long-term condition that must be monitored and managed throughout your life. It is estimated that 1 million people in the US have ulcerative colitis and although it can develop at any age, it most commonly develops between the ages of 15 and 30.

What causes ulcerative colitis?

Ulcerative colitis is an autoimmune condition, meaning the body starts attacking certain parts of itself as it recognizes them as foreign, rather like it would with an infection which is a foreign invasion of viruses or bacteria.

The underlying cause is not known but is likely to be a complex mix of factors. Genetics plays a part - some of your family members may suffer from ulcerative colitis or other related conditions - and its course may be influenced by some aspects of diet and lifestyle, leading to the body's immune system acting inappropriately.

Treatment aims to reduce bowel inflammation with medications such as steroids, salicylates, and immunosuppressants. Some may need to stay on long-term medications to control symptoms, and some may experience complications that require surgery to remove part of the bowel.

Other autoimmune or inflammatory conditions can be more common if you have ulcerative colitis. It's common to get inflammation with the joints, especially those of the hand; eye problems, such as an inflammatory condition known as uveitis; skin problems, such as psoriasis; and a lower back problem called ankylosing spondylitis.

Ulcerative colitis is not contagious and cannot be passed on from person to person, but it may be inherited.

Is diet an important factor?

Ulcerative colitis is not a food intolerance, but there is some evidence that certain dietary changes may help symptoms - following a high-calorie diet or lactose-free diet are two examples. These may be recommended by your specialist team alongside medications to reduce the inflammatory response.

There's some evidence that improving your gut microbiome balance could reduce inflammation and keep your condition under control. A recent study showed that Symprove, a probiotic supplement, reduced test inflammatory markers.

You could try anti-inflammatory foods such as those rich in omega 3, turmeric, and psyllium husk as soluble fiber. Vitamin C-rich foods and ginger may help protect the intestinal lining.

You are at risk of anemia, so make sure you have enough iron-rich foods, or you could try supplements and seek out vitamin B foods or supplements to help with any fatigue.

Am I fit for work?

You are unfit for work if you have a flare of ulcerative colitis. If your symptoms are manageable, you may be fit for work.

When should I see my doctor?

If you have diarrhea with blood, mucus, or abdominal pain, you should book an appointment with your doctor. If the symptoms are severe or you are unwell, book an urgent doctor's appointment.

The doctor will ask about your symptoms and, if necessary, examine you. Depending on the possible diagnosis, blood tests, urine or stool tests, or imaging (ultrasound, X-ray, CT scan) could be carried out, or you may be referred to a specialist department. The doctor may also prescribe some medication to help with your symptoms.

In the long term, it's likely you will have a specialist team to monitor your condition and advise on treatment to best suit you. Once your ulcerative colitis is under reasonable control, they may ask your doctor to take over care, but will be on hand for any future flare-ups.

Unfortunately, this condition also puts you at an increased risk of bowel cancer. You will be under regular surveillance to monitor this, as symptoms of colitis and bowel cancer can appear to be similar, so it can be difficult to spot without regular tests.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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