Ulcerative colitis makes swelling, inflammation, and sores in the lining of the large intestine (colon) and causes diarrhea, belly pain, and bleeding from the rectum. It's a lifelong condition, but in most people the symptoms come and go.
Medicines can stop or reduce symptoms and prevent flare-ups. If the disease is severe, you may need surgery to remove the colon.
What are the symptoms of ulcerative colitis?
The main symptoms of ulcerative colitis are:
- Belly pain or cramps.
- Bleeding from the rectum.
Some people also may have a fever, may not feel hungry, and may lose weight. In severe cases, people may have diarrhea 10 to 20 times a day.
The disease can also cause other problems, such as joint pain, eye problems, skin problems, or liver disease.
In most people, the symptoms come and go. Some people go for months or years without symptoms (remission) and then have a flare-up. A few people have symptoms all the time.
What causes ulcerative colitis?
Experts aren't sure what causes ulcerative colitis. It might be caused by the immune system overreacting to normal bacteria in the digestive tract. Or other kinds of bacteria and viruses may cause it. You are more likely to get it if other people in your family have it.
How is ulcerative colitis diagnosed?
To diagnose ulcerative colitis, a doctor will ask about your symptoms, do a physical exam, and do a number of tests. Testing can help rule out other problems that can cause similar symptoms, such as Crohn's disease and irritable bowel syndrome.
Tests that may be done include:
- Colonoscopy. In this test, a doctor uses a thin, lighted tool to look at the inside of your entire colon. At the same time, the doctor may take a sample (biopsy) of the lining of the colon.
- Blood tests to check for infection or inflammation.
- Stool sample testing to look for blood, infection, and white blood cells.
How is ulcerative colitis treated?
Treatment is done to improve your symptoms and to heal your colon. Treatment depends on:
- How bad the disease is.
- What treatments have worked.
- Your age.
- If you have certain infections, such as Clostridioides difficile (or C. diff).
- For mild or moderate cases of the disease when there is little risk of needing surgery, most people can be treated with pills or rectal medicines. These medicines reduce inflammation and calm down the immune system. Some people need steroid medicines.
- For moderate or severe cases of the disease when there is a high risk of needing surgery, medicines (such as biologics) are used to prevent inflammation. These are given intravenously (I.V.) or as a shot. Other medicines to calm down the immune system may be needed. Some people need steroid medicines.
You might need surgery to remove the colon:
- If it's an emergency, such as a problem like toxic megacolon.
- If medicines don't help your symptoms, or if side effects are causing problems.
Surgery almost completely reduces the risk of colon cancer.
When to call
Ulcerative colitis: When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- Your stools are maroon or very bloody.
Call your doctor now or seek immediate medical care if:
- You have new or worse belly pain.
- You have a fever.
- You have new or worse nausea or vomiting.
- You have new or more blood in your stools.
- You cannot pass stools or gas.
- You have pus draining from the area around the anus or pain and swelling in the anal area.
Watch closely for changes in your health, and be sure to contact your doctor if:
- You have new or worse symptoms, such as diarrhea that gets worse.
- You are losing weight.
- You do not get better as expected.
Caring for yourself when you have ulcerative colitis
You can take steps at home to reduce symptoms of ulcerative colitis and take care of yourself.
- Take diarrhea medicines.
If your diarrhea isn't well controlled, ask your doctor if there are over-the-counter medicines you can use.
- Avoid medicines that can make ulcerative colitis worse.
In general, doctors recommend that you don't use nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen). These medicines may cause flare-ups. But some people may be more likely to have flare-ups from NSAIDs than other people. Talk to your doctor about whether to avoid these medicines.
- Pay attention to what you eat and drink.
During a flare-up, avoid foods that make your symptoms worse. This may include foods that are high in fiber or high in fat. It may also include foods and drinks that have lactose, like dairy products.
Focus on getting enough fluids and on eating enough protein.
In between flares, you can go back to eating your normal diet.
- Get support.
Ulcerative colitis can affect every aspect of your life. You may want to seek counseling or social support from family, friends, or a faith leader. Or look for a support group.
Children can have worse ulcerative colitis symptoms than adults. It also can cause them to grow more slowly or even stop growing. That's why it's important to get care right away and follow a treatment plan. Support groups can provide emotional support as well as information to help a child cope with ulcerative colitis.
- Learn about ostomy care.
If you have had or are planning to have surgery that will create an ostomy, you may feel self-conscious or embarrassed. After a period of adjustment, most people are able to resume all of their usual activities. In fact, you may feel better than before surgery because you may no longer have painful symptoms. Support groups are available for people with ostomies.
Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.