What You Need to Know About Ulcerative Colitis

Get an overview of UC symptoms, diagnosis, and treatment options and learn how UC differs from Crohn’s disease.

Medically reviewed in December 2020

Ulcerative colitis (UC) is one of the two main types of inflammatory bowel disease (IBD), a chronic condition that affects an estimated 3 million adults in the United States. The other main type of IBD is Crohn’s disease.

UC versus Crohn’s
Both conditions cause inflammation and ulcers in the digestive tract. With UC, inflammation and ulcers primarily occur in the rectum and colon. With Crohn’s disease, inflammation and sores can occur in any section of the digestive tract (although the inflammation is not continuous and there are healthy sections of digestive tract as well).

Both conditions typically follow a cycle of remission and relapse, where symptoms disappear at times, and flare at others.

Symptoms of UC
Symptoms of UC can vary from person to person and vary in severity. The common symptoms of UC include:

  • Pain in the rectum
  • Rectal bleeding and/or blood in stool
  • Diarrhea and/or frequent but small bowel movements
  • The urgent need to have a bowel movement
  • Feeling like you need to have a bowel movement, but being unable to have a bowel movement
  • Abdominal pain and cramping, especially pain on the left side of the abdomen
  • Weight loss
  • Fatigue

UC Diagnosis
Many of the symptoms of UC can be caused by other conditions and diagnosis is made by eliminating the other potential causes of the symptoms.

An evaluation for UC may include a physical exam, questions about symptoms, blood samples, and stool samples. It may also include:

  • A CT scan of the abdomen to look for signs of complications
  • An endoscopic procedure (where the inside of the GI tract is examined with a thin, flexible camera)
  • Biopsies of tissue in the GI tract

Your healthcare provider will also ask questions about your medical history and your family’s medical history—family history and genetics are risk factors for UC.

It’s important to get a diagnosis as soon as possible. Patients who begin treatment earlier tend to have better treatment outcomes.

UC treatment
There is no cure for UC, but there are therapies that can help reduce inflammation, ease symptoms, and help people with UC live a normal life. Treatment may include:

  • Medications. Drugs called aminosalicylates (which reduce inflammation in the lining of the intestine), corticosteroids, immunosuppressant drugs, and biologic drugs can be used to treat UC.
  • Surgery. Surgery may be necessary if a person has unacceptable side effects from medication or develops a complication that requires surgery.
  • Avoiding triggers. Triggers are things that cause symptoms to flare or make symptoms worse. People with UC should avoid triggers, which may include stress as well as certain foods. Keeping a food and symptom journal can help you identify and track your triggers.
  • Nutrition. UC can cause anemia, nutritional deficiencies, and malnutrition. Your healthcare provider may advise you to make changes to your diet to address these problems.

It is important to remember that there is no one best approach for UC—the disease affects everyone differently, and everyone’s treatment plan will be a little bit different. Your best source of information about your health and treatment is your healthcare provider.

Centers for Disease Control and Prevention. "Inflammatory Bowel Disease Prevalence (IBD) in the United States."
UCLA Health. "Ulcerative Colitis vs Crohn's Disease."
Crohn's & Colitis Australia. "Understanding the remission and relapse cycle in Crohn’s disease."
American Academy of Family Physicians. "Patient Education: Inflammatory Bowel Disease (IBD)."
Robert C. Langan, Patricia B Gotsch, Michael A Krafczyk and David D Skillinge. "Ulcerative Colitis: Diagnosis and Treatment." American Family Physician, 2007. Vol. 76, No. 9.
UpToDate. "Patient education: Ulcerative colitis (Beyond the Basics)."
American Society of Gastrointestinal Endoscopy. "Endoscopic Procedures."
MedlinePlus. "Ulcerative colitis."
Catharine Paddock. "Large studies identify new risk genes for ulcerative colitis and IBD." Medical News Today.
Centers for Disease Control and Prevention. "What is inflammatory bowel disease (IBD)?"
Mayo Clinic. "Ulcerative colitis."
Cleveland Clinic. "Ulcerative Colitis: Management and Treatment."
Edyta Tulewicz-Marti, Andrzej Moniuszko and Grazyna Rydzewska. "Management of anemia in inflammatory bowel disease: a challenge in everyday clinical practice." Przeglad gastroenterologiczny, 2017. Vol. 12, No. 4.
Crohn's and Colitis Foundation Fact Sheet. "Common Micronutrient Deficiencies in IBD."
Crohn's and Colitis Foundation. "Malnutrition and IBD."

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