Ulcerative colitis: causes, symptoms, diagnosis and treatment

January 8, 2014 at 10:22 AM

Ulcerative colitis, in simple words, is an inflammation of colon. The incidences of this disease range between 1 to 20 cases per 100,000 individuals per year. The prevalence rate of this disease is 8 to 246 cases per 100,000 individuals per year. The incidences of this disease are higher in the northern countries of the world.


The exact cause of ulcerative colitis is unknown. But it’s believed that a number of factors contribute to the development of this condition. The most important causes of ulcerative colitis include:

(1) Auto-immunity

Most researchers believe that ulcerative colitis is an auto-immune disease. Your body has got a defense mechanism that protects it from harmful viruses and bacteria. The response body develops for fighting foreign materials is called inflammation. But in ulcerative colitis the inflammatory response, once triggered, doesn’t turn off even after bacteria and viruses are destroyed. This causes excessive damage to colon and ulcerative colitis as a result. Some hypotheses propose that body starts an exaggerated inflammatory response against good bacteria living in our gut. The result of which is ulcerative colitis.

(2) Genetic factors

Studies have shown that there is a strong relationship between ulcerative colitis and genetics. This disease tends to run in families. Studies have shown that 1 in 6 people suffering from ulcerative colitis have someone in their families suffering from same condition.

(3) Environmental factors

Environmental factors also contribute a great deal in the development of this disease. High level of pollutants in environment and eating a diet rich in carbohydrates and fats increase the risk of developing ulcerative colitis.


The severity of symptoms varies from individual to individual. Some people experience mild symptoms, while others might experience more severe symptoms. Moreover, the onset of symptoms can be gradual or sudden. The most important symptoms of ulcerative colitis include:

  • Pain in the abdomen or abdominal cramping.
  • Your stool might contain pus or blood in it.
  • Abdominal sounds are heard, which are splashing or gurgling in character.
  • The frequency and urgency of defecation increases i.e. diarrhea.
  • You might also experience some generalized symptoms like fever, weight loss and pain upon defecation (tenesmus).

Some symptoms, not related to gut, might also appear along with the usual symptoms of ulcerative colitis. These symptoms might include:

  • Arthralgia i.e. pain and swelling in the joints.
  • Ulcers on skin or in mouth.
  • A feeling of being nauseate all the times. You might also experience vomiting.
  • In children, the growth is usually retarded.


How to diagnose ulcerative colitis? How do you know that the condition you’re suffering from is ulcerative colitis and not anything else? A number of procedures are done that serve to diagnose ulcerative colitis:

  • The first thing that can help diagnose ulcerative colitis is the characteristic clinical findings including blood in the stool, tenesmus and diarrhea. Fever, a generalized feeling of being unwell and weight loss indicates severe attacks.
  • Blood tests are also valuable because a complete evaluation of blood profile might show signs like leucocytosis (increased number of white blood cells), thrombocytosis (increased number of blood clotting cells), iron deficiency anemia and elevated level of C-reactive proteins.
  • ESR (erythrocyte sedimentation rate) is usually elevated.
  • Colonoscopy provides a definite clinical picture. This procedure shows the inside of colon and characteristic findings of ulcerative colitis including mucosal ulceration, spontaneous bleeding and poor colon health.


Now we come to the big question here, what treatment options do you have when it comes to ulcerative colitis? Well, the treatment options include use of medicines, some dietary interventions, stress management and surgery. All these treatment options are discussed in detail in this section.

Nutrition for ulcerative colitis

Certain types of foods can complicate the gas, indigestion and diarrhea related to ulcerative colitis- especially when the disease is in its active state. So, following are some dietary recommendations for people suffering from this condition:

  • Don’t over eat. Avoid eating 1-2 large meals. Instead eat small amount of food throughout the day.
  • Drink ample water throughout the day.
  • If you’ve lactose intolerance in addition to ulcerative colitis, then its best that you limit the intake of dairy products because eating these products will worsen your abdominal cramping.
  • Avoid eating food that is rich in fats (butter, cream, oily chip and hamburgers).
  • Avoid food that is high in fiber as it can worsen your diarrhea. Such food includes seeds, barns, popcorn and nuts.

Medication for ulcerative colitis

A number of medicines are used in the treatment of ulcerative colitis. These medicines include:

  • Mesalamine or sulfazine (5-aminosalicylate) is the most important medicine when it comes to ulcerative colitis. It helps limit the symptoms of this disease.
  • Since this is an auto-immune disease, some immunomodulators are also used in its treatment. Such drugs include azathioprine and 6-mercaptopurine.
  • Corticosteroids suppress the exaggerated immune responses in the body and are a useful tool in the treatment of ulcerative colitis. Corticosteroids that are used in the treatment of this disease include prednisone and methylprednisone.
  • Some monoclonal antibodies like inflximab are also used for the treatment of ulcerative colitis.

Stress management and ulcerative colitis

There is a strong link between stress and ulcerative colitis. If you’re stressed due to some reason and this stress is chronic then you’re a more prone to develop this condition. Or if you already have this condition and you’re stressed all the times then it’ll further complicate your condition. Stress management has proved to be effective in the treatment of ulcerative colitis.

Anything that can help you reduce your stress can help you reduce the symptoms of ulcerative colitis as well. Stress relieving techniques include yoga and meditation.


When nothing works, the last resort is surgery. In this procedure the colon is removed. Surgery is used as a last resort when:

  • The dietary or medicinal interventions are not giving desired results.
  • There is a risk that inflammation might progress to cancer of colon.
  • Serious complications like intense bleeding and rupture of colon occurs.

Other information

Pictures related to ulcerative colitis

Ulcerative colitis found while performing an endoscopic procedure

Endoscopic image of ulcerative colitis


Ulcerative colitis explained

Ulcerative colitis explained in an easy to understand diagram


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Written by: Michal Vilímovský (EN)
Education: Physician
Published: January 8, 2014 at 10:22 AM
Next scheduled update: January 8, 2016 at 10:22 AM
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