Ulcerative colitis is a chronic condition in which the immune system mistakenly attacks the lining of the large intestine, causing inflammation and small open sores. It belongs to a group of disorders known as inflammatory bowel disease, or IBD. Unlike Crohn's disease, which can involve any part of the digestive tract, ulcerative colitis is limited to the colon and rectum and affects the innermost lining.
The condition usually alternates between flares, when symptoms are active, and remission, when the bowel is calm. It most often begins in younger adults, but it can appear at any age.
Common symptoms
Typical symptoms include diarrhea that may contain blood or mucus, cramping abdominal pain, and a frequent or urgent need to move the bowels. During flares, some people also have fatigue, poor appetite, weight loss, or fever.
Because the immune system is involved, ulcerative colitis can occasionally cause problems beyond the gut, such as joint aches, skin changes, or eye irritation. Severity varies widely from person to person and can change over time.
How it is diagnosed
Diagnosis brings together several pieces of information. Blood and stool tests look for inflammation, anemia, and infection. The central test is a colonoscopy, which allows your gastroenterologist to examine the lining of the colon directly and collect small tissue samples called biopsies. Biopsy results confirm the diagnosis and help distinguish ulcerative colitis from other conditions, including Crohn's disease.
Treatment and management
Treatment aims to calm the inflammation, relieve symptoms, and then keep the disease in remission. Several families of medicines are used, from anti-inflammatory drugs that work within the intestine to therapies that adjust the immune response. The best choice depends on how much of the colon is involved and how active the disease is.
Most people manage ulcerative colitis with medicines and regular follow-up. Surgery to remove the colon is reserved for severe disease that does not respond to treatment or for certain complications. Because long-standing inflammation can slowly raise the risk of colon cancer, your gastroenterologist will also set a schedule of periodic surveillance colonoscopies.
When to talk to a gastroenterologist
Talk to a gastroenterologist if you have ongoing diarrhea, blood in your stool, or abdominal pain that keeps returning. If you already live with ulcerative colitis, contact your care team when a flare does not settle, new symptoms appear, or your medicines cause concerns. Consistent follow-up is one of the strongest tools for staying in remission.
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