What is ulcerative colitis?
Ulcerative colitis is a chronic (lifelong) disease that causes inflammation and small sores (ulcers) in the lining of the large intestine (colon). Sometimes just called “colitis” or “UC,” it’s one of the most common types of inflammatory bowel disease (IBD). Because there is no cure yet, it’s important to seek care from IBD experts who specialize in diagnosing and treating ulcerative colitis. At our MedStar Georgetown Inflammatory Bowel Disease (IBD) Center, our multidisciplinary team provides compassionate, individualized care for patients living with the condition. By participating in research and clinical trials, our patients gain access to the latest diagnostic tools and treatment options helping to improve the quality of life for patients with ulcerative colitis.
What are the signs and symptoms of ulcerative colitis?
Ulcerative colitis symptoms can vary from person to person, ranging from mild to severe. Common signs of UC include:
- Abdominal pain
- Bloody diarrhea
- Rectal bleeding
- Fever
- Weight loss
If the inflammation spreads outside of the colon to eyes, skin, or other organs, it can cause additional health complications and symptoms. These may include:
- Joint pain
- Skin rashes or bumps
- Liver disease
- Eye pain or vision changes
What causes ulcerative colitis?
Ulcerative colitis is a complex immune-mediated disorder and we’re still trying to understand what causes it. Research suggests that genetics can increase your risk of colitis. Additionally, your gut’s microbiome (bacteria, virus and fungus ecosystem) may play a role. It’s important to note that eating certain foods does not cause ulcerative colitis. However, some foods or beverages can trigger or worsen symptoms for people living with the disease.
How do IBD experts diagnose ulcerative colitis?
Several different tests may help your doctor to evaluate your health and diagnose colitis. After performing a physical exam and asking questions about your personal and family medical history, diet, and lifestyle, your doctor may order one or more of the following:
- Blood tests
- Stool samples
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Endoscopy, which uses a thin lighted tube with a camera during various procedures, including:
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Colonoscopy to examine the entire colon and lower part of the small intestine (ileum)
- Sigmoidoscopy to assess your lower large intestine
- Upper endoscopy to evaluate the food pipe (esophagus), stomach and the upper part of your small intestine
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A colonoscopy is also used to screen for colon cancer and can be used to identify and remove colon polyps before they become cancerous. This is especially important for patients with colitis because chronic inflammation from IBD can increase an individual’s risk of colon cancer. If you are diagnosed in your 30s, your doctor may recommend earlier or more frequent colon cancer screenings to increase your chances of detecting cancer early when it is more easily treatable.
How is ulcerative colitis managed and treated?
The goal of ulcerative colitis treatment is to achieve and maintain remission, which occurs when your condition is inactive with few or no symptoms. It’s common for many patients with colitis to experience periods of remission and flare-ups, when inflammation and symptoms return. Following your personalized treatment plan is important for optimizing your health, reducing inflammation, suppressing symptoms, and lowering your risk of additional health complications.
Ulcerative colitis medications
Medication for ulcerative colitis is typically the primary treatment option. Several different medications may be used alone or in combination with others. These include:
- Mesalamine, an anti-inflammatory medication that works like an aspirin for the colon
- Oral small molecule drugs, which help to calm your immune system
- Biologics, which may be used to treat more moderate to severe colitis
- Steroids, which can be used for short periods of time to put out the fire
Learn more about IBD treatment
Surgery
If UC medication doesn’t provide symptom relief, or if medications stop becoming effective, your doctor may recommend surgery. When surgery is the best treatment option, we work closely with colorectal surgeons to get you the care you need. Generally, patients undergoing surgery have the entire colon and rectum removed in a procedure called a colectomy. A temporary ostomy (“bag”) formation is usually required.
Learn more about colorectal surgery
Optimizing your health
Ulcerative colitis can increase your risk of colon cancer and lead to additional health concerns, such as anemia or liver problems. That’s why your IBD team works closely to coordinate cancer screenings, vaccinations, and routine lab work to monitor your health and prevent serious illness whenever possible.
Our providers
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Lester Kenneth Bowser, MD
Gastroenterology
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Aaron Michael Fond, MD
Gastroenterology
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Parnia Ghazanfari, PA-C
Gastroenterology
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Joseph James Jennings, MD
Gastroenterology
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Shannan Elizabeth Richardson, CRNP
Gastroenterology
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Abhinav Sankineni, MD
Gastroenterology
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Atul Rasiklal Shah, MD
Gastroenterology
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Konika Sharma, MD
Gastroenterology
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Danny T. Shearer, MD
Gastroenterology
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Jill P. Smith, MD
Gastroenterology
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Gary William Thompson, MD
Gastroenterology
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Molly Cassella Valois, PA
Gastroenterology
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Richard B Williams, MD
Gastroenterology
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Angeline Kathlene Williams, AGACNP
Gastroenterology
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Marc Lyle Kozam, MD
Gastroenterology
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Joshua Aaron Rosenbloom, DO
Gastroenterology
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Patient stories
Frequently asked questions
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How is ulcerative colitis different from Crohn’s disease?
Ulcerative colitis and Crohn’s disease are the most common types of inflammatory bowel disease (IBD). Both are considered autoimmune diseases. However, where the inflammation occurs varies between the two. Patients with Crohn’s disease experience chronic inflammation anywhere along the digestive tract. In contrast, people with ulcerative colitis experience chronic inflammation solely in the lining of the large intestine. Both are serious conditions that require specialized care.
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Are there any natural remedies for ulcerative colitis?
Prescription medications are important for managing ulcerative colitis and symptoms, so there aren't any recommended alternative treatments to be utilized alone. However, some lifestyle changes may help you achieve and maintain remission or get through flare-ups. Natural remedies and suggestions that can complement your medication may include:
- Diet: Temporarily eliminating foods that trigger UC symptoms, such as whole grains, lactose, or processed foods
- Probiotics: Probiotics may be effective in helping to reduce the risk of infection in specific instances, such as if you have a J-pouch after a colectomy
- Physical activity: Regular exercise can help to reduce stress and fight fatigue
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What foods should you avoid with ulcerative colitis?
Ulcerative colitis isn’t caused by eating certain foods. However, some people with IBD experience more symptoms when they eat “trigger foods.” Temporarily eliminating or limiting the following foods and beverages may help reduce your symptoms:
- Spicy foods
- Whole grains
- Dairy (yogurt, cheese, and milk)
- Seeds and nuts
- Added sugar
- Packaged foods
- Sugary and/or caffeinated beverages
- Alcohol
It’s always a good idea to talk to your IBD provider or a dietitian before starting any special diets. They can help you understand your specific nutritional needs and identify any diet modifications that may help minimize your UC symptoms.