Ulcerative colitis (UC) is a chronic disease that causes inflammation and ulcers in the inner lining of the large intestine and rectum. If you have UC, you may experience repeated cycles of flare-ups (symptomatic periods) and remissions (asymptomatic periods).
A flare-up can last a few days or a few weeks and then be followed by a remission that lasts for months or even years. How long a flare-up lasts depends on the following factors:
- The severity of the disease (mild, moderate, or severe)
- Triggers such as stress, infection, diet changes, etc.
- Medication compliance (whether you're taking your medications as prescribed)
While there is no cure for UC, several treatment options and lifestyle modifications can help reduce symptoms or prevent flare-ups.
What causes ulcerative colitis?
The exact cause of ulcerative colitis is unknown. The following are factors that can contribute to the disease:
- Genetics: People who have first-degree relatives with UC are at increased risk of UC.
- Immune response: Autoimmune disorders can cause your immune system to attack the cells in your body instead of defending them.
- Environmental factors:
- Diet (high levels of fat, sulfur and meat)
- Certain medications
- Alcohol and substance abuse
- Psychological stress
- Consumption of milk may exacerbate the disease if you are lactose-intolerant.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of UC.
What are the signs and symptoms of ulcerative colitis?
UC can cause the following signs and symptoms:
- Rectal bleeding
- Frequent stools (more than four a day)
- Mucous discharge from the rectum
- Tenesmus (feeling you need to have a bowel movement even if you already had one)
- Abdominal distention/bloating
- Lower abdominal pain and cramps
- Severe diarrhea and cramps
- Dehydration (in cases of severe diarrhea)
- Increased heart rate
- Weight loss
UC is also linked to other symptoms like inflammation of the eyes, joints, skin, and lungs.
How do doctors classify ulcerative colitis?
UC is classified as mild, moderate, or severe:
- Mild: Rectal bleeding and fewer than four bowel movements per day
- Moderate: Rectal bleeding with more than four bowel movements per day
- Severe: Rectal bleeding with more than four bowel movements per day and systemic illness with protein loss
What are treatments for ulcerative colitis?
Treatment for UC depends on the severity of the disease and often involves both medications and lifestyle modifications.
Most people require a combination of medications to suppress and/or modulate the immune system:
- Anti-inflammatory drugs: Anti-inflammatory drugs such as 5-aminosalicylates (sulfasalazine, balsalazide, etc.) and corticosteroids (prednisolone, budesonide, etc.) suppress the cells that cause inflammation. These drugs are usually the first step in the treatment of UC and are well tolerated by most people.
- Immune system suppressors: Immunosuppressant drugs work by suppressing the immune system response that stimulates the inflammation process. Examples include Azasan and Imuran (Azathioprine); Purinethol and Purixan (Mercaptopurine); Gengraf, Neoral and Sandimmune (Cyclosporine), and Xeljanz (Tofacitinib).
- Biologics (monoclonal antibodies): Biologics target and neutralize proteins produced by the immune system. Examples include Remicade (Infliximab), Humira (Adalimumab), and Simponi (Golimumab). Entyvio (Vedolizumab) is a type of biologic that works by blocking the inflammatory cells from reaching certain parts of the body and can be used for people who can't tolerate other biologics.
- Anti-diarrheal medications: Your doctor may recommend anti-diarrheal medications such as Imodium (Loperamide) for severe diarrhea. You should avoid taking over-the-counter (OTC) anti-diarrheal medications without consulting your doctor because they can increase the risk of toxic megacolon (an enlarged colon).
- Painkillers: Tylenol (acetaminophen) is safe to use for pain relief. Talk to your doctor before taking other OTC pain medications.
- Antispasmodic medications: Antispasmodic medications can help reduce cramps.
- Nutritional supplements: Iron supplements and vitamin D can help with anemia (iron deficiency) caused by chronic intestinal bleeding.
If you have stopped responding to medications or they're just not effective anymore, surgery is an option. You can undergo a proctocolectomy, which removes the colon and rectum, followed by reconstructive surgery.
Lifestyle and dietary modifications
Managing stress and emotions is crucial to preventing and decreasing flare-ups. Regular exercise and eating a healthy diet are important as well. Your doctor may encourage you to follow a diet that is low in fat and has moderate amounts of soluble fiber and vitamins.
What foods are safe for people with ulcerative colitis?
Foods that are usually tolerated well by people with UC include the following:
- Breads, noodles, and pastas made from refined white flour
- Boiled white rice
- Crackers and cereals made from white flour
- Cooked fruits
- Fruits without peels and seeds
- Cooked vegetables without skins and seeds
- Pureed vegetables and vegetable soups
- Soft, tender meats without skin
- Nut butters
- Oils like coconut oil or olive oil
- Death Count Climbs in Outbreak Linked to Recalled Eyedrops
- Birth Control Pills Tied to Slight Rise in Breast Cancer Risk, Regardless of Formulation
- Walking & Talking at Same Time: Aging Brain May Make It Tougher
- Medication Shortage Means Many With Advanced Prostate Cancer Are Missing Treatments
- Stress Urinary Incontinence? Know Your Surgical Options
- More Health News »
Health Solutions From Our Sponsors
Top How Long Does an Ulcerative Colitis Flare-Up Last Related Articles
What Is Balloon Endoscopy?Balloon endoscopy is a procedure used to view the small intestine and the digestive track. There are two types of balloon endoscopy, single balloon and double balloon. Balloon endoscopy is used to diagnose and treat diseases of the esophagus, stomach, duodenum, and colon (large intestine).
Crohn's Disease vs. Ulcerative Colitis (UC)Crohn's disease and ulcerative colitis are diseases that cause inflammation of part of or the entire digestive tract (GI). Crohn's affects the entire GI tract (from the mouth to the anus), while ulcerative colitis or ulcerative colitis only affects the large and small intestine and ilium. Researchers do not know the exact cause of either disease. About 20% of people with Crohn's disease also have a family member with the disease. Researchers believe that certain factors may play a role in causing UC. Both Crohn's disease and ulcerative colitis are a type of inflammatory bowel disease, or IBD.
Crohn's disease and ulcerative colitis both have similar symptoms and signs, for example, nausea, loss of appetite, fatigue, weight loss, episodic and/or persistent diarrhea, fever, abdominal pain and cramping, rectal bleeding, bloody stools, joint pain and soreness, eye redness, or pain. Symptoms unique to Crohn’s disease include anemia and skin changes. Symptoms of unique to ulcerative colitis include, certain rashes, an urgency to defecate (have a bowel movement). Doctors diagnose both diseases with similar tests and procedures. While there is no cure for either disease, doctors and other health care professionals can help you treat disease flares, and manage your Crohn's or ulcerative colitis with medication, diet, nutritional supplements, and/or surgery.
Is Ulcerative Colitis an Autoimmune Disease?Ulcerative colitis (UC) is considered to be an autoimmune disease. With autoimmune disorders, your immune system goes awry and attacks your own body instead of defending it from infections and illnesses.
Is Ulcerative Colitis Curable?Ulcerative colitis is an inflammatory bowel disease (IBD) that affects the inner lining of the large intestine (large bowel or colon) leading to erosion and ulcers. It is also associated with various manifestations outside of the colon, such as inflammation of the eyes, joints, skin, and lungs. Ulcerative colitis is a lifelong illness with no specific cause or cure. Patients have repeated cycles of flare-ups and disappearance of the disease.
What Is the Life Expectancy of Someone With Ulcerative Colitis?Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that affects the inner lining of the large intestine (large bowel) leading to erosion and ulcers. It is a lifelong illness with no specific cause or cure.
Ulcerative ColitisUlcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
Ulcerative Colitis QuizWhat is ulcerative colitis and what risks are associated with suffering over the long term? Take this Ulcerative Colitis Quiz to learn causes, symptoms, and treatments for this painful digestive disorder.
Ulcerative Colitis Diet Plan
An ulcerative colitis diet plan can help a person with the disease avoid foods and drinks that trigger flares. There also are foods that can soothe ulcerative colitis symptoms during a flare. Types of ulcerative colitis plans include
- a high-calorie diet,
- a lactose-free diet,
- a low-fat diet,
- a low-fiber diet (low-residue diet), or
- a low-salt diet.
Self-management of ulcerative colitis using healthy lifestyle habits and a nutrient rich diet can be effective in management of the disease. Learn what foods to avoid that aggravate, and what foods help symptoms of the disease and increase bowel inflammation.
Ulcerative ColitisUlcerative Colitis is a form of inflammatory bowel disease and is slightly different than Crohn's disease. Learn the causes, symptoms, diet, and treatment options associated with ulcerative colitis.
Ulcerative Colitis SurgeryUlcerative colitis surgery is performed on approximately 25% to 40% of people with the disease. There are various types of ulcerative colitis. Complications of the surgery include pouch failure, intestinal blockage from adhesions, inflammation of the pouch, and more watery and frequent bowel movements.
What Is the Best Treatment for Ulcerative Colitis?Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that affects the inner lining of the large intestine (large bowel) leading to erosion and ulcers. It is a lifelong illness with no specific cause or cure. Patients have repeated cycles of flare-ups and remission with potential extraintestinal (beyond the bowel) manifestations, such as joint pain, eye pain, and skin rashes.
When Do You Need Ulcerative Colitis Hospitalization?Ulcerative colitis is an inflammatory bowel disease that can be life-threatening when the symptoms flare up. You need ulcerative colitis hospitalization if you have more than six bowel movements per day, blood in your stool, high temperature and heart rate, and severe abdominal pain.