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pANCA (perinuclear anti-neutrophil cytoplasmic antibodies) – seen in many UC patients
ASCA (less common in UC; more associated with Crohn’s)
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
Doctors use a mix of tests to diagnose UC:
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
Treatment depends on the severity and location of the disease:
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 to help control symptoms
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
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
Slightly more common in men for rectal involvement and in women for extensive disease
More common in people of Ashkenazi Jewish and European descent
Crohn’s & Colitis Foundation. (2023). Ulcerative Colitis.
https://www.crohnscolitisfoundation.org/what-is-ulcerative-colitis
Mayo Clinic. (2023). Ulcerative Colitis.
https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis
NIH – National Institute of Diabetes and Digestive and Kidney Diseases. (2022). Ulcerative Colitis.
https://www.niddk.nih.gov/health-information/digestive-diseases/ulcerative-colitis
Ungaro, R., et al. (2017). Ulcerative colitis. The Lancet, 389(10080), 1756–1770.
https://doi.org/10.1016/S0140-6736(16)32126-2
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