Diet and Nutrition

What Is Ulcerative Colitis?

What Is Ulcerative Colitis?

There are a few problems that can affect the digestive tract and cause problems, and they are generally referred to as irritable bowel diseases (IBD). The most common IBDs are Crohn’s disease and ulcerative colitis. IBD is different from IBS – Irritable Bowel Syndrome, which does not cause inflammation and damage to the bowel. IBS is a functional disorder where the digestive system does not work properly. It is characterized by inflammation of the large intestine – the colon and the rectum.

The actual cause of ulcerative colitis is unknown even today. It is how the body's immune system reacts to environmental, dietary, or infectious foreign bodies which causes inflammation in the intestinal wall. Though the disease is not caused by emotional distress or sensitivity to certain foods, these factors may still trigger symptoms in some people. Ulcerative colitis is most likely an infection of the intestine which leads to patients suffering with recurrences of the symptoms.

Ulcerative colitis (UC) is diagnosed when the colon and/or rectum develop ulcers and become inflamed. The result of these conditions is varied, but those who suffer from UC often complain about:

  • persistent diarrhea
  • increased urgency to perform bowel movements
  • increased frequency of bowel movements
  • abdominal pain
  • blood and/or pus in the stool
  • extreme fatigue
  • loss of appetite and, subsequently, loss of weight

How does ulcerative colitis develop?

The gut is usually resistant to most kinds of infections, but it may be defenseless against those that originate from within. Stretching all the way from the mouth to the anus, the gut is lined by a protective layer of mucus that keeps it safe from harm by digestive enzymes and other materials.

With ulcerative colitis, though, the colon and rectum lose this protection. Instead, the inner layer of the colon becomes inflamed, and it eventually develops ulcers which are painful. As the colon keeps getting irritated by more food particles and other enzymes, the inflammation becomes more serious and the ulcers more extensive, which can even cause bleeding.

Unlike other IBDs, like Crohn’s disease which can affect any part of the digestive tract, UC is always localized to the colon, but it may also extend to the rectum.

Why does the colon become irritated?

Nobody really knows why some people’s colons become inflamed and develop UC while others don’t, but researchers have a number of theories:

Autoimmune disorder

Autoimmune disorders refer to states where the body’s natural defenses produce unfavorable results. Within the colon, the immune system is responsible for producing antibodies to fight off any potential infections which may be harmful to the body. However, the body sometimes gets it wrong, mistakenly identifying food particles and healthy gut bacteria as dangerous. In response, the body sends white blood cells to the lining of the colon to fight these substances.

White blood cells can cause inflammation, which is supposedly temporary to neutralize the danger. If your body mistakenly identifies food and healthy bacteria as harmful, then it keeps sending even more white blood cells, leading to increased inflammation which eventually develops into ulcers.


Various traits are passed on from one generation to the next, and so can the likelihood of developing UC. The increased sensitivity to foreign particles in the gut can be inherited by children from their parents, raising their probability of developing ulcerative colitis. This is why almost 20% of cases of ulcerative colitis are found in those whose parents suffer from the same condition.

Environmental factors

Whatever you eat has to go through the colon and to the rectum, and some people’s bodies may react negatively to certain foods. The exact foods that may result in ulcerative colitis will vary from one person to another.

However, experts argue that diet alone is not sufficient cause to lead to ulcerative colitis, but it may trigger relapses in those who are already at risk.

Living with ulcerative colitis

Making dietary changes that include fiber reduces the chances of getting affected with any diseases of the digestive system. The diet should involve sufficient amount of protein, carbohydrates, and healthy fibers. Reducing spicy and oily food will also help increase immunity. Making a food habit of including 2-3 portions of fruits and vegetables in your daily diet is also beneficial. Stress, too, plays a major factor in the life of UC patients. Less stress means lesser recurrence of IBD. Since it is a chronic disease, medications will be needed. You should also monitor what you eat and when the symptoms increase. This will help the doctor prescribe suitable medication.

What are the symptoms of ulcerative colitis?

The most common symptoms of ulcerative colitis are bloody diarrhea and abdominal pain. Patients may also experience increased body temperature, rectal bleeding, fatigue, anemia, loss of appetite, and weight loss. Since the body loses fluids regularly and nutrients get lost as a result of the diarrhea, nutritional deficiencies can occur. These symptoms occur as intermittent attacks in between periods when the symptoms go away. These disease-free periods can last for months or even years. Usually, an attack begins with increased urgency to defecate, mild lower abdominal cramps, and blood and mucus in the stools.  

Ulcerative colitis may cause long-term problems such as arthritis, inflammation of the eye, liver diseases (fatty liver, hepatitis, and cirrhosis), osteoporosis, skin rashes, anemia, and also kidney stones. These complications may occur when the immune system triggers inflammation in other parts of the body. These problems can disappear when the colitis is treated effectively.

How is ulcerative colitis diagnosed?

The doctor will conduct a thorough physical examination and blood tests to diagnose ulcerative colitis. Anemia, if detected, can indicate bleeding in the intestine or in the rectum. If the blood tests reveal a high white blood count, it will indicate the presence of inflammation or infection. A stool sample will also be tested to check if there is a specific bacterial or parasite infection, or if there is internal bleeding in the intestine.

A colonoscopy test done as an outpatient procedure will also help doctors diagnose the extent of the damage to the intestine. The doctor will insert an endoscope – a long, flexible tube equipped with a camera and biopsy instruments – into the anus and view the inside of the colon and rectum. Inflammation, bleeding, and ulcers can be detected. The doctor may also take out samples of tissue from the colon and check it under a microscope. The patient will be asked to drink a barium solution, which will show up as white on an X-ray, allowing the doctor to see the ulcers or any other abnormality.

What is the treatment for UC?

Treatment depends on the severity of the disease after conducting several tests. Most people would need mild to strong medication. Some people, whose symptoms are triggered by certain foods, are able to control the symptoms by avoiding food that upset their digestive system. Dairy products, spicy foods, highly-seasoned foods, large amount of protein intake should be avoided. Treatment will be advised differently for different patients. A family member providing emotional support is also advised. Patients with ulcerative colitis would need medical care for a long period of time, with regular visits to the doctor to monitor the condition.