What Is Ulcerative Colitis?
Ulcerative colitis (UC) is a chronic inflammatory bowel disease that causes inflammation and ulcers in the lining of the colon (large intestine) and rectum. Unlike Crohn's disease, UC only affects the large intestine and always involves the rectum.
Symptoms
- Diarrhoea — often with blood and mucus
- Urgency to open bowels
- Abdominal cramping and pain
- Weight loss and fatigue
- Fever during flares
- Anaemia from blood loss
Diagnostic Tests
| Test | Purpose |
|---|---|
| Faecal calprotectin | Elevated — confirms intestinal inflammation; separates from IBS |
| Full Blood Count | Anaemia, elevated platelets and WBC |
| CRP & ESR | Elevated in active disease |
| Stool culture | Rules out infectious colitis (Clostridium difficile) |
| Colonoscopy + biopsy | Definitive diagnosis — shows characteristic pattern |
| Iron studies | Iron deficiency anaemia from blood loss |
| Albumin | Low in severe disease — nutritional marker |
Treatment
- Mild-moderate: aminosalicylates (mesalazine) — oral and rectal
- Moderate-severe: corticosteroids for flares
- Maintenance: azathioprine, mercaptopurine
- Severe/refractory: biologic drugs (infliximab, adalimumab, vedolizumab)
- Surgery: colectomy if medical treatment fails or cancer develops
FAQs
Is UC the same as Crohn's disease?
Both are IBD but different. UC: colon only, continuous inflammation from rectum. Crohn's: anywhere in the GI tract, patchy inflammation, can be transmural (full bowel wall).
Does UC increase cancer risk?
Yes — risk of colon cancer rises after 8–10 years of extensive colitis, requiring regular surveillance colonoscopies.
Can UC go into remission?
Yes — many patients achieve long-term remission with medications. UC typically cycles between remission and flares.
Medical Disclaimer: IBD management requires regular follow-up with a gastroenterologist. Never stop your medications without medical advice.