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Ulcerative Colitis Facts

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.


Ulcerative Colitis Overview

Ulcerative colitis is an inflammatory bowel disease (IBD). It is a long-term, chronic medical condition that involves inflammation and ulcers in the colon lining and in the rectum. This causes tiny open sores and ulcers. The cause remains unknown. While diet and stress may aggravate this condition, they do not cause it.

There are three different types of this medical condition, including:

  • Ulcerative proctitis - limited to the rectum
  • Left-sided colitis - begins in the rectum extends into the colon
  • Extensive colitis (pancolitis) - affects entire colon

The highest number of cases are found in developed countries and warmer climates, while the lowest number are found in developing regions. The overall incidence rate for ulcerative colitis worldwide is 39 cases per 100,000 people.

Symptoms of Ulcerative Proctitis

The symptoms of ulcerative proctitis are rectal bleeding, pain and urgency in bowel movements. The other two types of this disease have the following symptoms:

  • Diarrhea with blood or pus
  • Abdominal pain with cramping
  • Weight loss
  • Bloody diarrhea
  • Urgency to defecate
  • Inability to defecate despite urgency
  • Fatigue
  • Rectal pain and bleeding
  • Fever
Outline of the Digestive System

Outline of the Digestive System

Risk Factors

Men or women may get this disease, and heredity plays an important role. Risk factors include:

  • Age: Symptoms usually presents before age 30 but can occur at any age
  • Race or ethnicity
  • Family history: Higher risk if a close relative has this disease


Your physician must rule out other illnesses, and the physician will complete a physical examination before ordering other medical tests. Those tests include:

  • Blood tests: To rule out anemia or signs of an infection
  • Stool samples: To look for infection signs, parasites and inflammation
  • Imaging tests: MRI or CT scan to look at the colon and rectum
  • X Ray: Abdominal x-ray to look for a perforated colon
  • Endoscopic tests: A thin, flexible tube with a tiny camera used for a colonoscopy or sigmoidoscopy

Ulcerative Colitis Treatment-Mayo Clinic


Treatments are typically medications or surgery if necessary. Medications recommended by doctors include:

  • Anti-inflammatory meds: sulfasalazine (Azulfidine), mesalamine (Asacol HD, Delzicol)
  • Corticosteroids: prednisone and budesonide
  • Immune system suppressors: Azathioprine (Azasan, Imuran) and mercaptopurine (Purinethol, Purixan) are the most common, Cyclosporine (Gengraf, Neoral, Sandimmune) for those unresponsive, Tofacitinib (Xeljanz) also for the unresponsive
  • Therapies that target proteins made by the immune system: Infliximab (Remicade), adalimumab (Humira) and golimumab (Simponi), Vedolizumab (Entyvio), Ustekinumab (Stelara)
  • Anti-diarrheal medication
  • Pain relievers
  • Antispasmodics
  • Iron supplements as necessary

Surgery that removes the entire colon and rectum for the most serious cases. The surgeon will

Surgery can eliminate ulcerative colitis and involves removing your entire colon and rectum (proctocolectomy). The surgeon will use the small intestine and use a procedure called ileoanal anastomosis (J-pouch) surgery, which will allow you to expel waste relatively normally.

Possible Complications

There are several possible complications for this disorder, and they include:

  • Severe bleeding
  • Severe dehydration
  • Perforated colon
  • Bone loss (osteoporosis)
  • Inflammation of your joints, skin and eyes
  • Increased of colon cancer
  • Increased risk of blood clots in arteries or veins
  • A rapidly swelling colon (toxic megacolon)
Intestinal wall.

Intestinal wall.

Dietary Recommendations

If you are in a flare-up you don’t want to eat foods that irritate your colon, but you still want to get an adequate amount of nutrients, vitamins, and minerals. Ideally, you eat low fiber fruits, lean protein and refined sugars.

Avoid the following foods:

  • “Fruits with skin and seeds, raw green vegetables (especially cruciferous vegetables such as broccoli, cauliflower, or anything with a peel), whole nuts, and whole grains;
  • Lactose: sugar found in dairy, such as milk, cream cheese, soft cheeses Non-absorbable sugars, high fat foods: butter, coconut, margarine, and cream
  • Alcohol and caffeinated drinks
  • Spicy food”

Ulcerative colitis: Fresh Approaches to Taming Inflammation

Final Thoughts

This can be a very difficult disease to live with due to the very uncomfortable side effects. There is no way to avoid this disease, but a well-balanced diet will help control all of the symptoms. Eating food that contains probiotics is a healthy choice such as yogurt or kefir.

Stanford scientists have linked this disease to missing gut microbes, which are bacteria found in a healthy gut. This microbe makes metabolites that keep the gut healthy. There is a vast amount of ongoing research. While they have a better understanding of this disease there is no cure.


This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2021 Pamela Oglesby