Autoimmune Disease

Ulcerative colitis – The types, causes, and treatments

A type of inflammatory bowel disease (IBD), ulcerative colitis is a condition that triggers chronic inflammation and ulcers in the colon and rectum. It is characterized by a variety of signs and symptoms, including diarrhea with blood or pus, rectal pain and bleeding, abdominal cramps, fatigue, fever, weight loss, and an urgency to defecate. Ulcerative colitis affecting kids might also hamper their growth.

Types of ulcerative colitis
Ulcerative colitis is classified by doctors based on its location:

  • Ulcerative proctitis: In this type, only the anus suffers from inflammation. Additionally, the only other symptom of ulcerative proctitis is rectal bleeding. This is the mildest form of ulcerative colitis.
  • Proctosigmoiditis: In proctosigmoiditis, along with the rectum, the sigmoid colon, that is, the lower part of the colon, is inflamed. Abdominal cramps, tenesmus, and diarrhea with pus are some other symptoms involved.
  • Left-sided colitis: In this condition, the inflammatory symptoms affect the rectum, sigmoid, and descending colon. Pain on the left side, bloody diarrhea, abdominal pain, and unexplained weight loss are some of its other symptoms.
  • Pancolitis: Pancolitis usually affects the entire colon, causing multiple episodes of bloody diarrhea, fatigue, abdominal pain, and weight loss.
  • Acute severe ulcerative colitis: A rare form of ulcerative colitis, this condition affects the whole colon system and triggers severe symptoms such as abdominal pain, fever, rectal bleeding, profuse diarrhea, and loss of appetite.

Causes of ulcerative colitis
Medical investigators haven’t been able to narrow down the exact cause of ulcerative colitis. Earlier, it was believed that poor diet and stress both contributed to the development of this condition. However, recent studies have shown that an immune system malfunction could be responsible for it. Scientists suspect that when the immune system attacks a bacteria or virus, it accidentally ends up damaging the healthy cells in the digestive system too.

People falling into the following categories are more likely to develop ulcerative colitis:

  • People under the age of 30
  • People belonging to the Caucasian or Ashkenazi Jewish race
  • People with a family history of ulcerative colitis

If this disorder is left untreated, it can lead to further complications such as severe bleeding, bone loss, dehydration, inflammation of the eyes, joints, and skin, a serious swelling of the colon, an amplified risk of blood clots, and perforated colon.

To accurately diagnose ulcerative colitis, doctors may use multiple means, including blood and stool exam, colonoscopy, flexible sigmoidoscopy, x-ray, abdominal CT scan, computerized tomography (CT) enterography, and magnetic resonance (MR) enterography.

Treating ulcerative colitis
Depending on the symptoms, the doctors might prescribe a combination of the following stated treatment options:


  • Anti-inflammatory medications such as 5-aminosalicylates and corticosteroids to lower the inflammation levels
  • Immune system suppressors for regulating the immune system response so that the inflammation of the colon could be reduced
  • Antibiotics for preventing or controlling infections
  • Anti-diarrheal medications
  • Iron supplements to correct anemia caused by excessive chronic intestinal bleeding
  • Pain relievers for abdominal and rectal pain

If the symptoms are severe and persistent, the doctor might suggest a surgery known as proctocolectomy, that is, the removal of the entire colon and rectum. To facilitate this, the stool collection and elimination, an ileal pouch-anal anastomosis will be carried out, where the surgeon creates a pouch that connects the small intestine to the anus. This excludes the necessity of wearing a bag to collect stool.

In some cases, the ileal pouch-anal anastomosis isn’t feasible, so one will have to opt for the ileal stoma procedure, where a permanent opening will be made in the abdomen to help collect the stool in an attached bag.