Ulcerative colitis is a long-term disease, causing inflammation in the innermost lining of the bowel and rectum.

Understanding (1)

It is a biologically chronic disease also known as Inflammatory bowel disease (IBD). In this disease, the innermost lining of the rectum and bowel get inflamed. Small ulcers and open sores start developing on the colon. These ulcers sometimes get breached and cause bleeding or the production of pus.


Symptoms of Ulcerative colitis are not abrupt and occur over time. These vary according to the severity and location of the disease. The most common symptoms of Ulcerative colitis are:

  • Recurring diarrhoea with pus, mucus, or blood
  • Pain and cramping in the abdomen
  • Pain in rectum
  • Urgent need to defecate bowel
  • Improper defecation
  • Loss of weight
  • Fever
  • Fatigue
  • Delayed growth in children

Most patients experience symptoms mild to moderate in severity. The symptoms are not one time and can flare up again. In the flare-up stage, a patient can experience symptoms in other body parts as well. Such as:

  • Arthritis that includes swollen and painful joints
  • Mouth ulceration
  • Swollen, painful, and red areas of skin
  • Redness and irritation in the eyes

The severity of the disease is determined by the frequent defecation of the bowel, which can be more than 6 times a day. In this case, a patient may face:

  • Breath shortness
  • Irregular and fast heartbeats
  • Stool with bloodstains

The specific cause that triggers flare-ups is yet not identified but gut infection is considered to be the cause. Along with that, stress and anxiety are also supposed to be the triggering roots.

Causes (2)

The exact underlying cause of Ulcerative colitis is unidentified. Many doctors think it is due to the abnormal response of the immune system.

  • Autoimmune condition

The immune system defends the body from foreign agents. Once this system identifies the foreign body it commands white blood cells to fight against that foreign body. The result causes redness and swelling at the site of infection.

The colon is the human body that contains normal flora that helps in removing toxins and digestion of food. In the case of Ulcerative Colitis, the immune system mistakenly attacks the normal flora of the colon, causing it to get inflamed and red.

According to some experts, the immune system does not turn off after fighting with a certain infection and causes inflammation in the colon, which turns into Ulcerative colitis.

Some researchers believe that no other infection is involved but the immune system hyper responds by itself. Imbalanced bad and good bacteria in the bowel are also thought to be the reason for Ulcerative colitis.

  • Genetics

Inherited genes can also be the underlying cause of Ulcerative colitis. According to the research, 70% of people suffering from ulcerative colitis have a family history of the same disease.

A higher ratio of this disease in people of certain ethnicity also supports the idea of genetics as an underlying cause. Some researchers have observed that certain genes in a person make him more prone to the condition and these genes have a great influence on the immune system.

  • Environmental factors

Region and one’s way of living also affect his chances of getting Ulcerative colitis. This means environmental factors also play a role in the onset of Ulcerative colitis. For instance, if the region is observed then this disease is more common in northern parts of America and Western Europe.

Multiple environmental factors that are associated with the onset of Ulcerative colitis are observed. It includes medication, air pollution, and certain diets. Moreover, a large number of people are seen with this condition in areas with improved sanitation. This means less bacterial exposure can be the cause of Ulcerative colitis as well.


  • Ulcerative proctitis: in this type, only the nearest part of the rectum gets inflamed, causing rectal bleeding.
  • Proctosigmoiditis: in this type, the sigmoid colon and rectum get inflamed, causing improper defecation, pain and cramps in the abdomen, and bloody diarrhea.
  • Left-sided colitis: in this, descending part of the colon and Sigmoid get inflamed, causing an urgent need to defecate, pain and cramping on the left side of the abdomen, and bloody diarrhea.
  • Pancolitis: in this type, the whole colon gets inflamed, causing frequent bloody diarrhea, weight loss, fatigue, pain, and cramps in the abdomen.


Lab test

  • Stool test: certain biomarkers that are certain proteins and white blood cells are seen in a stool sample. It indicates the likelihood of Ulcerative colitis.
  • Blood test: blood test is carried to check the presence of anemia. It also helps to rule out other disorders.

Endoscopic procedures

  • Colonoscopy: In this method, a doctor examines the entire colon. This is done by using a flexible and thin tube. The camera on the end of the tube shows the inner image of the entire colon. The biopsy can also be done during this procedure.
  • Flexible sigmoidoscopy: with a help of a flexible and thin tube, the doctor examines the sigmoid colon and rectum.

Imaging procedures

  • X-ray: in severe conditions, the doctor conducts an abdominal X-ray to rule out other suspected complications such as colon perforation.
  • CT scan: abdominal and pelvic CT scan is done to check Ulcerative colitis-associated complications.
  • CT enterography and MR enterography: these are non-invasive methods. These are more sensitive and accurate tests in determining the inflammation than the above tests.


  • Anti-inflammatory drugs

These are the first-line treatment of Ulcerative colitis. This treatment is suitable for the majority of people.

  • 5-aminosalicylates: this drug is taken as an enema, orally or in the form suppository depending upon the area of inflammation.
  • Corticosteroids: These medications are given when the disease does not respond to the above medications.
  • Immune system suppressants

These drugs suppress the immune response and ultimately reduce inflammation. In some cases, the disease responds to combination therapy more effective than the one medicine alone. Examples are Azathioprine, Mercaptopurine, Cyclosporine, and Tofacitinib.

  • Biologics

Biologics, such as Infliximab, Vedolizumab, and Ustekinumab target the protein, which causes Ulcerative colitis and treats the severity of the condition.


  1. https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/symptoms-causes/syc-20353326#:~:text=Ulcerative%20colitis%20(UL%2Dsur%2D,over%20time%2C%20rather%20than%20suddenly.
  2. https://www.nhs.uk/conditions/ulcerative-colitis/causes/