What Is Ulcerative Colitis (UC)?

• Ulcerative proctitis affects only the rectum.
• Left-sided colitis affects the rectum, sigmoid colon, and descending colon up to the sharp bend near the spleen.
• Extensive colitis or pancolitis affects the entire colon.

• Age: UC can occur at any age, but it is more likely in people younger than 15 or older than 60.
• Family history: Having a close family member with UC or another autoimmune disease increases your risk.
• Race and ethnicity: White people and people of Ashkenazi Jewish descent have a greater risk of developing UC.

• Blood tests: Blood tests, including a complete blood count and C-reactive protein test, can help check for signs of anemia, inflammation, or infection, which can indicate UC.
• Stool sample: A stool sample can check for signs of inflammation and help rule out other causes, such as an infection from bacteria or parasites.
• Imaging tests: A magnetic resonance imaging or computed tomography scan examines your small intestine to help rule out other conditions, such as Crohn’s disease.
• Endoscopic procedures: Like a colonoscopy, these involve a camera on a flexible tube or capsule to examine parts of your digestive system.

Medication Options

• 5-aminosalicylates: These are typically the first-line of treatment for mild ulcerative colitis. They work by reducing inflammation directly in your digestive tract and can be taken on an ongoing basis.
• Corticosteroids: These are also known simply as steroids, and they are used to treat UC flare-ups. Most drugs of this type work by suppressing the entire immune system. Because of this, they can have severe side effects and shouldn’t be taken for long periods.
• Biologics and small molecules: Biologics are made of antibodies that are grown in a lab and work by stopping certain proteins in the body from causing inflammation. Small molecules are oral medications that also work on the immune system but act differently from biologics.
• Immunomodulators: These drugs reduce inflammation by suppressing the activity of your immune system. They are sometimes used in combination with biologics for severe cases of UC.
• Acetaminophen (Tylenol): Tylenol may be used to help relieve pain symptoms of ulcerative colitis. However, certain drugs, including ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), may make symptoms worse.

Surgery

• Proctocolectomy with ileal pouch (J-pouch): After the colon and rectum are removed, the surgeon then creates a pouch from the end of the small intestine and attaches this to the anus. This is an alternative to a long-term ostomy.
• Proctocolectomy with ileostomy: In some cases, an ileal pouch may not be possible. Instead, the surgeon will fix an opening from the intestine to your skin, which allows for emptying of waste.

• Limit or avoid dietary triggers: If certain foods trigger UC symptoms for you, it can help to eat less of them or avoid them altogether. Triggers vary from person to person. If you’re not sure how to identify your triggers, it can help to keep a food diary to track how certain foods make you feel. Or you may want to meet with a registered dietitian for professional help.
• Stay hydrated: Drink plenty of water each day. Try to limit or avoid caffeine, alcohol, and carbonated beverages, which can irritate the gut.
• Eat smaller, more frequent meals: Eating five to six small meals a day may be gentler on your gut than three large meals a day.
• Do your best to manage stress: Although stress doesn’t cause UC, it may make your symptoms worse. Activities such as exercise, meditation, and deep breathing exercises can help ease stress.

• Eat smaller amounts of food throughout the day.
• Drink plenty of water.
• Limit insoluble fiber, a type of fiber that the body doesn’t digest and is more irritating to the gut than soluble fiber, a type of fiber that the body does digest.

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• Avoid greasy or fatty foods.
• Limit dairy products, if you’re lactose intolerant.

• Severe bleeding
• Perforated colon, or holes or tears in the colon
• Anemia, or low red blood cell count
• Arthritis
• Colorectal cancer
• Toxic megacolon, where the colon rapidly swells
• Slowed growth and development in children

The Crohn’s & Colitis Foundation is the leading nonprofit organization focused on research and support for people with IBD. Their mission is to cure Crohn’s disease and ulcerative colitis and improve the quality of life of Americans living with IBD.

• Ulcerative colitis is a chronic inflammatory condition that affects the colon.
• Symptoms include urgency, frequent bowel movements, and bloody stools.
• While surgery to remove the colon is the only definitive long-term treatment, most people can manage the condition with medications and lifestyle adjustments.