Ulcerative colitis is a long-term (chronic) condition affecting the colon.
Symptoms include:
- bloody diarrhoea
- abdominal pain
- a frequent need to go to the toilet
- weight loss
These can range from mild to severe, with the condition being unpredictable. Symptoms can flare up and then disappear (known as remission) for months or even years.
Read more about the symptoms of ulcerative colitis.
Treatment
There is currently no cure for ulcerative colitis so the aim of treatment is to relieve symptoms during a flare-up and prevent symptoms from returning during remission – this is known as maintenance therapy.
Medications such as aminosalicylates and corticosteroids (steroid medications) are used for this.
Mild to moderate "flare-ups" can usually be treated at home. A severe flare-up needs treating in hospital as there is a chance of serious complications developing.
Surgery may be required to remove a section of the colon, if medication fails to work.
Read more about treating ulcerative colitis.
What causes ulcerative colitis?
Ulcerative colitis is thought to be what is known as an autoimmune condition. This means the immune system – the body’s defence against infection – goes wrong in some way and attacks healthy tissue.
One theory is the immune system mistakes harmless bacteria inside the colon as a threat and attacks the tissues of the colon, causing it to become inflamed. In severe cases, painful sores may form which bleed and produce mucus and pus.
Exactly what causes the immune system to behave in this way is unclear. Most experts think a combination of genetic and environmental factors is involved.
Read more about the causes of ulcerative colitis.
Complications
Complications include:
- inflammation of the bile ducts (tubes that transport bile out of the liver) – this is known as primary sclerosis cholangitis and can cause symptoms such as itchy skin and tiredness
- gases becoming trapped inside the colon, causing it to swell – this is known as toxic megacolon and requires emergency treatment as it can be life-threatening
People with ulcerative colitis also have an increased risk of developing bowel cancer. Because of this, regular bowel cancer check-ups are recommended.
Read more about the complications of ulcerative colitis.
Who is affected
Ulcerative colitis is an uncommon condition. It is estimated one new case will be diagnosed each year for every 1,000 people in England.
The condition normally appears in a person between the ages of 15 and 30.
It's more common in white people of European descent – especially those descended from Ashkenazi Jewish communities – and black people. The condition is much rarer in people of Asian background. The reasons for this are unclear.
Both men and women seem to be equally affected by ulcerative colitis.
Outlook
The outlook for most people with ulcerative colitis is usually quite good. Symptoms are often mild to moderate and can be controlled with medication.
However, an estimated one-in-five people with ulcerative colitis have severe symptoms that fail to respond to medication. In these cases, it may be necessary to surgically remove the colon.
