ulcerative_colitis_infographicUlcerative Colitis Overview

Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that affects the large intestine, or colon, and the rectum.

It is one of the two main forms of IBD, along with Crohn’s disease.

Although the exact cause of ulcerative colitis is unknown, it is thought to be the result of an abnormal response by the body’s immune system.

Instead of fighting off infections as it’s supposed to, the immune system attacks the cells of the colon lining, leading to inflammation and ulcers.

Ulcerative colitis (UC) is characterized by inflammation and sores, or ulcers, in the inner lining of the large intestine (colon) and rectum.


Understanding the Condition:


The exact cause of ulcerative colitis is not known, but it’s thought to result from an abnormal immune response.

This means the body’s immune system mistakenly attacks the cells in the digestive tract, causing inflammation and ulcers.

Genetic factors and environmental triggers may also play a role in the development of this condition.




The symptoms of ulcerative colitis can vary widely among individuals, depending largely on the severity and extent of the inflammation. Common symptoms include:

  • Diarrhoea, often with blood or pus
  • Abdominal pain and cramping
  • Rectal pain
  • Rectal bleeding
  • Urgency to defecate
  • Difficulty defecating despite urgency
  • Weight loss
  • Fatigue
  • Fever
  • In children, failure to grow or develop properly

In severe cases, individuals may experience additional symptoms such as:

  • Dehydration
  • Rapid heartbeat
  • Anemia (a reduction in red blood cells that can cause fatigue and weakness)
  • Reduced appetite and weight loss

Ulcerative colitis symptoms can vary in severity and may come and go, with periods of acute symptoms (known as flare-ups) and periods of remission when symptoms subside.

The disease can be debilitating and can sometimes lead to life-threatening complications.

If you experience persistent changes in your bowel habits or other symptoms of ulcerative colitis, it’s important to seek medical attention.



Causes of Ulcerative Colitis


In ulcerative colitis, the immune system mistakes food, bacteria, and other materials in the intestine for foreign or invading substances.

When this happens, the body sends white blood cells into the lining of the intestines, where they produce chronic inflammation and ulcerations.

The disease usually begins gradually and can become worse over time, with symptoms varying depending on the severity of inflammation and where it occurs. Therefore, treatment aims to reduce the inflammation that triggers your symptoms.

The cause of ulcerative colitis remains unknown, but it is likely the result of an interaction between genes, the immune system, and environmental factors.

It can occur at any age but is usually diagnosed in people between the ages of 15 and 30.
The condition can significantly affect an individual’s quality of life, but with the right treatment, it can be managed effectively.




How can Ulcerative Colitis be Diagnosed?


Ulcerative colitis is typically diagnosed through a combination of medical history, physical examination, and specific diagnostic tests. Here are the common steps in diagnosing ulcerative colitis:

Medical History and Physical Exam: The doctor will ask about your symptoms, family history of inflammatory bowel disease (IBD), and any medications you’re currently taking. They will also perform a physical exam to check for signs of illness.


Blood Tests: These can help identify signs of inflammation, such as a high white blood cell count, or anemia, which could indicate bleeding in the colon or rectum. Blood tests can also help rule out other potential causes of your symptoms, like an infection.


Stool Test: This can help rule out other disorders, such as infections or parasites, which can cause similar symptoms.


Endoscopic Procedures:

Colonoscopy: This is the most common test for diagnosing ulcerative colitis. A thin, flexible tube with a camera on the end (a colonoscope) is inserted into the rectum to view the entire colon. The doctor can also take small samples of tissue (biopsies) for laboratory analysis, which can help confirm a diagnosis.


Flexible Sigmoidoscopy: This procedure is similar to a colonoscopy, but it allows the doctor to examine the rectum and the lower part of the colon only.


Imaging Tests: In certain situations, a doctor may recommend an X-ray, CT scan, or MRI to get a detailed image of the colon and to check for complications.


Biopsy: A biopsy, or small sample of the lining of the colon, is often taken during a colonoscopy or sigmoidoscopy. The biopsy is then examined under a microscope to confirm the diagnosis.


Treatment Options:


While there’s no cure for ulcerative colitis, treatments can significantly help manage the condition and improve the quality of life for individuals living with it.

Treatment focuses on reducing inflammation, managing symptoms, and inducing and maintaining remission. Treatment options include:

  • Medications:
    Anti-inflammatory drugs, such as amino salicylates and corticosteroids, are often the first line of treatment. Immune system suppressors can also be used, either alone or in combination with anti-inflammatory drugs. In cases of severe symptoms, biologic therapies, which target specific substances involved in the inflammatory process, may be used.
  • Diet and Lifestyle Changes:
    While diet and stress do not cause ulcerative colitis, they can trigger flare-ups and make symptoms worse. A balanced, nutritious diet can help manage symptoms and promote healing. Avoiding foods that seem to trigger symptoms, managing stress, and regular exercise can also help manage the condition.
  • Surgery:
    Surgery is seen as a last resort in the management of UC. If medications aren’t effective, or if there are complications such as massive bleeding, a perforation of the colon, or a risk of cancer, surgery may be required. The surgery may involve removing the entire colon and rectum (proctocolectomy).

Remember, it’s essential to work closely with your healthcare provider to develop a personalized treatment plan if you have ulcerative colitis.

Regular check-ups and monitoring are also important, as individuals with this condition have an increased risk of colon cancer.

Despite the challenges, many individuals with ulcerative colitis lead fulfilling lives with the right treatment and management strategies.


Lifestyle Changes

Ulcerative colitis (UC) is a chronic condition that requires long-term management.

In addition to medication, lifestyle changes can play a crucial role in managing symptoms, preventing flare-ups, and promoting overall health.

Here are some lifestyle changes that may help when diagnosed with UC:

Dietary Changes
: There is no specific diet that has been proven to treat ulcerative colitis, but certain types or categories of food might exacerbate symptoms during a flare-up. These can vary from person to person, but they often include high-fiber foods, dairy products, spicy foods, alcohol, and caffeine. Keeping a food diary may help identify personal triggers.


Hydration: Diarrhea and bleeding can lead to dehydration. It’s essential to drink plenty of fluids, especially water. Avoid alcohol and caffeine as they can exacerbate diarrhea.


Regular Exercise: Regular physical activity can help reduce stress, maintain a healthy weight, and promote overall well-being. However, during a flare-up, you may need to adjust your routine and intensity.


Stress Management: Stress doesn’t cause ulcerative colitis, but it can trigger a flare-up and make symptoms worse. Techniques such as meditation, deep breathing, yoga, or tai chi may help manage stress levels.


Regular Check-ups: Regular appointments with your doctor can help monitor the condition, adjust treatment as needed, and catch and address complications early.


Medication Adherence: It’s essential to take all medications as prescribed by your doctor, even when you’re feeling well, to prevent flare-ups and complications.


Rest: Adequate sleep is vital for overall health and can help your body recover during flare-ups. Try to get a good night’s sleep and rest when needed.


Support: A chronic illness like UC can be emotionally challenging. Don’t hesitate to seek support from friends, family, or support groups, and consider speaking with a mental health professional if needed.

Remember, everyone’s experience with UC is unique, and what works for one person may not work for another.

Always consult your healthcare provider before making significant lifestyle changes.



Join a Clinical Trial

Currently we are recruiting patients for Crohn’s and Ulcerative colitis trials.

Dr George and Dr Deetlefs are clinical investigators at Spoke Research Inc and became involved in Clinical Research in 2017, and now runs the Inflammatory Bowel Disease trials.


If you’d like to take part in a clinical trial, join us here:

Apply for Crohn’s Disease Trial

Apply for Ulcerative Colitis Trial

We are here to provide you with expert medical advice in the field of clinical research with years of experience.

Contact us to find out more on clinical trials and treatment.


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Mediclinic Milnerton,
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Cape Town


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