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Definition

Ulcerative colitis (UC) is a type of severe, chronic inflammatory bowel disease (IBD), which causes:

  • Inflammation in the lining of the colon and rectum
  • Ulcers in the lining of the colon and rectum
  • Bleeding in the lining of the colon and rectum
Ulcerative Colitis
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Causes

The exact cause is unknown. A virus or bacteria may cause the immune system to overreact and damage the colon and rectum.

Risk Factors

Having a family member with IBD (includes UC and Crohn's disease ) may increase your risk of developing UC.

Symptoms

UC may cause:

  • Diarrhea
  • Abdominal cramps and pain
  • Rectal bleeding
  • Anemia
  • Weight loss
  • Fatigue, weakness
  • Nausea
  • Fever
  • Skin rashes
  • Arthritis
  • Eye inflammation, such as uveitis

Intestinal complications of UC may include:

  • Perforation
  • Fistula—abnormal passageway between 2 bodily structures
  • Obstruction
  • Excess bleeding
  • Toxic megacolon—a potentially life-threatening condition when the colon severely expands, which may result in reduced blood flow

Other complications of UC may include:

Diagnosis

The doctor will ask about your symptoms and medical history and perform a physical exam. Your doctor may order tests, such as:

Treatment

Treatment options may include:

Dietary Changes

Your doctor may recommend that you avoid certain foods, such as:

  • Dairy (due to lactose intolerance )
  • Alcohol
  • Red and processed meats
  • Refined sugar
  • Saturated fat

Talk to your doctor or dietitian about what foods may work best for you.

Medications

There are a range of medications that may be prescribed, such as:

  • Aminosalicylates
  • Steroid anti-inflammatory medications
  • Immune modifiers
  • Biological agents

Surgery

Surgery involves partial or complete removal of the colon . This may be necessary for:

  • An emergency, such as a perforation, excessive bleeding, or life-threatening infection
  • Long-term disease that does not respond to medications or other treatment
  • Colon cancer —includes confirmed diagnosis or suspicious tissue on examination
  • Lack of growth because of nutritional deficiencies (in children)

Surgery for UC is curative and reduces the risk of colon cancer.

Prevention

There are no current guidelines for preventing UC.

Revision Information

  • Reviewer: Daus Mahnke, MD
  • Review Date: 09/2013 -
  • Update Date: 07/23/2014 -
  • American Gastroenterological Society

    http://www.gastro.org

  • Crohn's and Colitis Foundation of America

    http://www.ccfa.org

  • The Canadian Association of Gastroenterology

    http://www.cag-acg.org

  • Crohn's and Colitis Foundation of Canada

    http://www.ccfc.ca

  • D'Haens GR, Sartor RB, et al. Future directions in inflammatory bowel disease management. 2014;8(8):726-734.

  • Richman S, Schub T. Ulcerative colitis. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/nursing/products/nursing-reference-center. Updated August 2012. Accessed September 5, 2012.

  • Ulcerative colitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 12, 2014. Accessed July 25, 2014.

  • Wedlake L, Slack N, et al. Fiber in the treatment and maintenance of inflammatory bowel disease: a systematic review of randomized controlled trials. Inflamm Bowel Dis. 2014;20(3):576-586.

  • What is ulcerative colitis? Crohn's & Colitis Foundation of America website. Available at: www.ccfa.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis. Accessed September 5, 2012.