Ulcerative Colitis: Causes, symptoms, diagnosis, and treatment
Ulcerative colitis is a type of inflammatory disease that can damage the colon and rectum. So, know the symptoms and possible treatments for this.
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Last updated on 3rd Jul, 2025
Ulcerative colitis is a long-term (chronic) condition that causes inflammation in the lining of the colon and rectum. It is a form of inflammatory bowel disease (IBD) characterised by symptoms like abdominal pain, diarrhoea, fatigue and rectal bleeding. And when they are not treated on time, they can also lead to serious complications like colon cancer. So, knowing the causes, symptoms, and treatment options can help improve the quality of life for those who suffer.
Causes of Ulcerative Colitis
A definitive cause of ulcerative colitis is as yet unknown; however, medical research suggests that genetic and environmental factors play a role in its development. Here is more on that –
Genetic Factors: Ulcerative colitis has a genetic component. Research indicates that those with a family history of IBDs are at a higher risk of developing the condition themselves. Some genes associated with ulcerative colitis are involved in immune function and inflammation.
Environmental Influence: Environmental factors like diet and stress can also cause or exacerbate ulcerative colitis. Unhealthy fat and processed foods are often cited as contributing factors.
Immune response: Research has shown that ulcerative colitis can be caused by an interaction between a bacterial or viral infection and the body's immune response. For instance, it can happen due to temporary inflammation caused by a normal immune response.
Symptoms of Ulcerative Colitis
Ulcerative colitis symptoms may develop gradually and vary in severity from mild to severe. While they mainly impact the digestive system, they can also affect other parts of the body. The common symptoms include –
Abdominal Pain: Abdominal pain is a featured symptom of ulcerative colitis, characterised by muscle cramping and bloating.
Diarrhoea: Another significant symptom of ulcerative colitis is diarrhoea, which may lead to significant dehydration and weakness.
Fatigue: Chronic fatigue is a common complaint of this illness, which can disrupt normal routines and overall quality of life.
Weight Loss: Because of continuous bouts of diarrhoea and a decreased capacity to absorb nutrients, many individuals with ulcerative colitis will experience unexplained weight loss.
In severe cases of ulcerative colitis, symptoms may include:Severe abdominal cramp
Blood, pus or mucus in stool
Dehydration
Consult Top General Gastroenterologist
Diagnosis of Ulcerative Colitis
Ulcerative colitis is diagnosed based on medical history, physical examination, and laboratory tests to confirm the disease. The doctor will start by assessing the medical records, including questions about the patient's symptoms, family history of IBD, and previous medical conditions.
After the initial check-up, the doctor may recommend the following tests –
Colonoscopy: This is considered the definitive method of diagnosing ulcerative colitis. It allows the doctor to see inside the colon and take biopsies of the affected tissue.
Stool Tests: Analysis of stool samples to check for infections and the presence of blood or inflammatory markers.
Blood Tests: To check for evidence of anaemia, infection, or inflammation.
Imaging Studies: CT scan, barium enema (a specialised type of X-ray) or MRI may be utilised to rule out complications such as toxic megacolon or abscesses.
Treatment Options for Ulcerative Colitis
Ulcerative colitis treatment aims to reduce inflammation, manage symptoms, and maintain remission. Management approaches depend on the severity of the disease and the patient's response to an initial therapy.
Ulcerative colitis is treated with several different medications, each addressing various aspects of the disease:
Aminosalicylates (5-ASAs): Anti-inflammatory drugs such as sulfasalazine or mesalamine are typically the first line of treatment for mild to moderate ulcerative colitis. They assist in healing inflammation in the colon and alleviate symptoms.
Corticosteroids: Corticosteroids such as budesonide and prednisone are used for short-term flares to rapidly reduce inflammation. However, they are not recommended for long-term use because of side effects such as osteoporosis and weight gain.
Immunosuppressive Drugs: These drugs, such as azathioprine or methotrexate, suppress the immune system to prevent it from attacking the colon. They are usually given for moderate to severe cases.
Biologics: These medications, including infliximab or adalimumab, target specific immune system pathways involved in inflammation. These are suitable for treating severe ulcerative colitis.
Moreover, surgeries are reserved for patients with intractable symptoms or debilitating complications. Common surgeries include:
Colectomy: This is the removal of the colon; in extreme cases, this may be necessary.
Ileal Pouch-Anal Anastomosis (IPAA): During this surgery, an internal pouch is created to facilitate the normal elimination of waste from the body after removing the colon.
Managing Ulcerative Colitis
Managing ulcerative colitis requires more than just medical treatment. Here are some lifestyle changes that are equally important –
Stress Management: Techniques such as yoga, meditation and deep-breathing exercises can lower the number of flare-ups.
Regular Exercise: Daily exercise can promote well-being, relieve stress and support digestion.
Rest and Sleep: Another vital aspect is resting well, as this is a commonly experienced symptom of the condition.
At the same time, diet can be key for managing ulcerative colitis. According to the American Gastroenterological Association (AGA), ulcerative colitis patients should follow a Mediterranean diet. That means they should eat a lot of fruits, vegetables, healthy fats, lean protein, and whole grains. Also, following these tips can manage the condition to some extent:
Avoid trigger foods/drinks such as spicy foods, caffeine and carbonated drinks.
Eating small amounts at a time instead of big meals reduces digestive stress.
Patients must drink plenty of water to stay hydrated, especially during flare-ups.
Complications of Ulcerative Colitis
Ulcerative colitis can have serious effects on overall health if it is not treated properly.
Toxic Megacolon
Colonic perforation
Osteoporosis
People with ulcerative colitis, particularly those with long-standing disease, are at an increased risk of developing cancer of the colon or rectum. So, it is vital to have regular screening. Also, some people are at risk of developing liver diseases, including primary sclerosing cholangitis.
Ulcerative Colitis in Different Age Groups
Ulcerative colitis can develop in individuals of any age. In most cases, the disease starts between the ages of 15 and 30. Then, it matures in individuals between 50 and 70. Some research has found that people over 65 are more likely to get a diagnosis and surgery for ulcerative colitis than younger ones.
Children with ulcerative colitis may experience slow growth, developmental delays, symptoms, and frequent flare-ups. On the other hand, ulcerative colitis in adults happens due to long-term chronic symptoms or fertility issues.
Prognosis and Quality of Life
Depending on the severity, ulcerative colitis can disrupt daily life with symptoms like diarrhoea, fatigue, and abdominal pain. However, with early diagnosis and proper treatment, many people with ulcerative colitis can lead active lives, but they need to manage the condition throughout their lives.
Conclusion
Ulcerative colitis is a chronic inflammatory condition that mainly affects the colon. Most people with ulcerative colitis experience it after a long period of having no symptoms. The causes of ulcerative colitis include many risk factors. However, with the right diagnosis and treatment, one can get relief from the disease. Most people easily manage it by avoiding triggers and adopting certain lifestyle modifications.
Consult Top General Gastroenterologist
Consult Top General Gastroenterologist
Dr Rohit Sureka
Gastroenterology/gi Medicine Specialist
19 Years • MBBS, DNB General Medicine, DNB Gastroenterology
Jaipur
Triveni Gastro Care, Jaipur
Dr Harish K C
Gastroenterology/gi Medicine Specialist
15 Years • MBBS MD DM MRCP(UK) (SCE-Gastroenterology and Hepatology)
Bangalore
Manipal Hospital, Bangalore
Dr. Paramesh K N
Gastroenterology/gi Medicine Specialist
16 Years • MBBS, MS ( General Surgery), DNB ( Surgical Gastroenterology)
Hyderabad
Sprint Diagnostics Centre, Hyderabad
Dr. Vijay Rai
Gastroenterology/gi Medicine Specialist
19 Years • MBBS,MD General Medicine,MD GASTROENTOLOGY
Kolkata
Livgastro, Kolkata
Dr. Gorantla Sarath Chandra
Gastroenterology/gi Medicine Specialist
15 Years • MD, DM (Gastro)
Hyderabad
Star Hospital, Financial District, Hyderabad
(225+ Patients)
Consult Top General Gastroenterologist
Dr Rohit Sureka
Gastroenterology/gi Medicine Specialist
19 Years • MBBS, DNB General Medicine, DNB Gastroenterology
Jaipur
Triveni Gastro Care, Jaipur
Dr Harish K C
Gastroenterology/gi Medicine Specialist
15 Years • MBBS MD DM MRCP(UK) (SCE-Gastroenterology and Hepatology)
Bangalore
Manipal Hospital, Bangalore
Dr. Paramesh K N
Gastroenterology/gi Medicine Specialist
16 Years • MBBS, MS ( General Surgery), DNB ( Surgical Gastroenterology)
Hyderabad
Sprint Diagnostics Centre, Hyderabad
Dr. Vijay Rai
Gastroenterology/gi Medicine Specialist
19 Years • MBBS,MD General Medicine,MD GASTROENTOLOGY
Kolkata
Livgastro, Kolkata
Dr. Gorantla Sarath Chandra
Gastroenterology/gi Medicine Specialist
15 Years • MD, DM (Gastro)
Hyderabad
Star Hospital, Financial District, Hyderabad
(225+ Patients)