Ulcerative Colitis

Ulcerative colitis is a long-term condition, where the colon and rectum become inflamed.

The colon is the large intestine (bowel), and the rectum is the end of the bowel where stools are stored. Small ulcers can develop on the colon’s lining, and can bleed and produce pus.

Symptoms of ulcerative colitis

The main symptoms of ulcerative colitis are:

The severity of the symptoms varies, depending on how much of the rectum and colon is inflamed and how severe the inflammation is. For some people, the condition has a significant impact on their everyday lives.

Some may go for weeks or months with very mild symptoms, or none at all (known as remission), followed by periods where the symptoms are particularly troublesome (known as flare-ups or relapses).

What causes ulcerative colitis?

Ulcerative colitis is thought to be an autoimmune condition. This means the immune system – the body’s defence against infection – goes wrong and attacks healthy tissue. The most popular theory is that the immune system mistakes harmless bacteria inside the colon for a threat and attacks the tissues of the colon, causing it to become inflamed. Exactly what causes the immune system to behave in this way is unclear. Most experts think it is a combination of genetic and environmental factors.

Who is affected

It is estimated that around 1 in every 420 people living in the UK has ulcerative colitis; this amounts to around 146,000 people. The condition can develop at any age, but is most often diagnosed between 15 and 25. It’s more common in white people of European descent (especially those descended from Ashkenazi Jewish communities) and black people. The condition is rarer in people of Asian background (although the reasons for this are unclear). Both men and women seem to be equally affected by ulcerative colitis.

How ulcerative colitis is treated

Treatment for ulcerative colitis aims to relieve symptoms during a flare-up and prevent symptoms from returning (known as maintaining remission).

In most people, this is achieved by taking medication such as aminosalicylates (ASAs) and corticosteroids.

Mild to moderate flare-ups can usually be treated at home. However, more severe flare-ups need to be treated in hospital to reduce the risk of serious complications, such as gas becoming trapped inside the colon, which can lead to swelling.

If medications are ineffective at controlling your symptoms, or your quality of life is significantly affected by your condition, surgery to remove your colon may be an option.

During surgery, your small intestine will either be diverted out of an opening in your abdomen (known as an ileostomy), or it will be used to create an internal pouch that is connected to your anus (known as an ileo-anal pouch).