Ulcerative Colitis

Ulcerative colitis is a chronic autoimmune disease that causes inflammation and sores (ulcers) in the lining of the large intestine (colon) and rectum. The body's immune system mistakenly attacks healthy tissue in the colon, leading to symptoms like diarrhea, abdominal pain, and urgency to use the bathroom. UC typically comes in flare-ups (when symptoms worsen) and remission periods (when symptoms improve or disappear). It can range from mild to severe and often impacts daily life.

Diarrhea, often with blood or mucus; Urgent need to use the bathroom; Abdominal pain and cramping (usually in the lower left side); Fatigue; Weight loss or poor appetite; Fever during flares; Anemia (due to blood loss); Joint pain, skin rashes, or eye inflammation (extraintestinal symptoms).

While the exact cause is unknown, UC is thought to result from a combination of genetics, immune dysfunction, and environmental triggers: Immune system malfunction (the immune system mistakenly attacks the colon's lining); Genetics (family history increases risk); Environmental triggers (infections, antibiotics, NSAIDs, and stress may contribute); Gut microbiome changes (imbalance of good and bad gut bacteria).

Colonoscopy or sigmoidoscopy with biopsy (confirm inflammation and ulcers); Stool tests to rule out infections; Blood tests for anemia or inflammation; Imaging (CT, MRI) in severe or uncertain cases.

Aminosalicylates (5-ASAs) like mesalamine to reduce inflammation; Corticosteroids for short-term control during flares; Immunomodulators (e.g., azathioprine) to suppress the immune system; Biologics (e.g., infliximab, adalimumab) to target specific immune pathways; JAK inhibitors for moderate to severe cases; Surgery to remove the colon (colectomy) in severe or treatment-resistant cases; Dietary changes and stress management.

UC is not curable (except by removing the colon), but it can be managed. Many people live normal lives with medication and care. Without treatment, complications may include severe bleeding, colon perforation, and increased risk of colon cancer (especially after 8-10 years of disease).

Affects about 1 in 400 people in the U.S. Most often diagnosed between ages 15 and 30, with a second peak around 50-70. More common in people of Ashkenazi Jewish and European descent.