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Ulcerative colitis is an autoimmune condition caused by the body’s immune system attacking itself. This causes continuous segments of inflammation in the gut wall, affecting the colon and rectum only.
2 in 1,000 adults in the UK are affected by ulcerative colitis.
Symptoms may vary depending on the length of gut affected and severity. The most common symptoms include:
Some patients may develop symptoms due to complications of their ulcerative colitis including bowel dilation, bowel leak or severe bleeding.
Some patients may also develop symptoms in other parts of the body including: skin rashes, mouth ulcers, joint pain, eye inflammation, and fragile bones.
Patients with ulcerative colitis are at increased risk of developing bowel cancer.
The causes of ulcerative colitis are not entirely known but it is thought to be a result of complex interactions between a person’s genes and their environment.
Having a family member with ulcerative colitis or another autoimmune condition is associated with an increased likelihood of developing ulcerative colitis.
Blood tests, stool samples and scans may all help in making a diagnosis.
The gold standard for diagnosis is to insert a flexible telescope into the anus and around the colon (colonoscopy) to collect a sample of tissue (biopsy) to be examined under a microscope.
Ulcerative Colitis Treatment
Treatment for ulcerative colitis is separated into two components. The first aim is to treat active symptoms (flare-up) and then once a flare-up is settled to maintain remission.
Treatment for ulcerative colitis is managed in specialist settings. Flare-ups are treated with a short course of immunosuppressant with an aminosalicylate (e.g. mesalazine, sulfasalazine) and/or corticosteroids.
Remission is maintained using a stepwise approach starting with an aminosalicylate and adding in second line therapies (e.g. azathioprine, 6-mercaptopurine) as required. Some patients may require treatment with special medications made from antibodies or surgery.
Medicinal cannabis can be considered when first and second line therapies have not achieved adequate benefit in active ulcerative colitis or disease that is in remission.
