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What Is Ulcerative Colitis (UC)?

What Is Ulcerative Colitis (UC)?
Everyday Health
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Updated on July 9, 2025
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Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD) in which the lining of the large intestine (colon) becomes inflamed and may produce mucus, blood, or pus.

 Inflammation of the colon also causes abdominal discomfort, frequent bowel movements, and bloody stools.

Types of Ulcerative Colitis

UC is divided into several subtypes, according to the part of the colon it affects:

  • Ulcerative proctitis affects only the rectum.
  • Left-sided colitis affects the rectum, sigmoid colon, and descending colon up to the sharp bend near the spleen.
  • Extensive colitis or pancolitis affects the entire colon.

Signs and Symptoms of Ulcerative Colitis

The most common symptoms of UC are urgency, bleeding, and diarrhea, which often contains mucus. Symptoms may develop gradually or suddenly and come and go.

People with UC can experience inactive periods, or remission, which may last months or years.

Over time, UC can progress to other areas of the colon and become more severe. This typically leads to increased symptoms.

Causes and Risk Factors of Ulcerative Colitis

The exact cause of UC is not fully understood, but it is believed to be an abnormal immune system response. There is no known way of preventing UC.

Normally, your immune system defends against harmful invasive bacteria and viruses. But in some people, the immune system mistakenly attacks the body’s own tissue.

While they don’t cause UC, stress and diet can trigger UC symptoms.

Risk factors for UC include:

  • Age: UC can occur at any age, but it is more likely in people younger than 15 or older than 60.
  • Family history: Having a close family member with UC or another autoimmune disease increases your risk.
  • Race and ethnicity: White people and people of Ashkenazi Jewish descent have a greater risk of developing UC.

How Is Ulcerative Colitis Diagnosed?

A colonoscopy to examine your entire colon, along with a tissue biopsy, is the best way to diagnose UC.

Other tests can help confirm a diagnosis and rule out other possible conditions. These include:

  • Blood tests: Blood tests, including a complete blood count and C-reactive protein test, can help check for signs of anemia, inflammation, or infection, which can indicate UC.
  • Stool sample: A stool sample can check for signs of inflammation and help rule out other causes, such as an infection from bacteria or parasites.
  • Imaging tests: A magnetic resonance imaging or computed tomography scan examines your small intestine to help rule out other conditions, such as Crohn’s disease.
  • Endoscopic procedures: Like a colonoscopy, these involve a camera on a flexible tube or capsule to examine parts of your digestive system.

Treatment and Medication Options for Ulcerative Colitis

Medications are the main treatment for UC. Other treatment options include dietary changes and surgery, if necessary.

Drugs for UC work by reducing inflammation in your colon.

Some drugs for UC are commonly used for maintenance, to help you stay in remission, while others help reduce activity during flare-ups. You may need a combination of these drugs for optimal treatment.

Surgery may be necessary if your body isn’t responding well to medication or if you have severe complications that require urgent treatment.

Medication Options

There are a few types of drugs that are used to treat ulcerative colitis:

  • 5-aminosalicylates: These are typically the first-line of treatment for mild ulcerative colitis. They work by reducing inflammation directly in your digestive tract and can be taken on an ongoing basis.
  • Corticosteroids: These are also known simply as steroids, and they are used to treat UC flare-ups. Most drugs of this type work by suppressing the entire immune system. Because of this, they can have severe side effects and shouldn’t be taken for long periods.
  • Biologics and small molecules: Biologics are made of antibodies that are grown in a lab and work by stopping certain proteins in the body from causing inflammation. Small molecules are oral medications that also work on the immune system but act differently from biologics.
  • Immunomodulators: These drugs reduce inflammation by suppressing the activity of your immune system. They are sometimes used in combination with biologics for severe cases of UC.
  • Acetaminophen (Tylenol): Tylenol may be used to help relieve pain symptoms of ulcerative colitis. However, certain drugs, including ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), may make symptoms worse.

Surgery

Surgery to cure UC is called a proctocolectomy and usually involves removing your entire colon and rectum.

  • Proctocolectomy with ileal pouch (J-pouch): After the colon and rectum are removed, the surgeon then creates a pouch from the end of the small intestine and attaches this to the anus. This is an alternative to a long-term ostomy.
  • Proctocolectomy with ileostomy: In some cases, an ileal pouch may not be possible. Instead, the surgeon will fix an opening from the intestine to your skin, which allows for emptying of waste.

Prevention of Ulcerative Colitis

There is no known way of preventing UC. However, treatment with medication or surgery and lifestyle changes, such as avoiding dietary triggers, can help you manage the condition and reduce your risk of flares.

Lifestyle Changes for Ulcerative Colitis

Along with medical treatment, it can help to make certain lifestyle changes to manage UC symptoms. These may include:

  • Limit or avoid dietary triggers: If certain foods trigger UC symptoms for you, it can help to eat less of them or avoid them altogether. Triggers vary from person to person. If you’re not sure how to identify your triggers, it can help to keep a food diary to track how certain foods make you feel. Or you may want to meet with a registered dietitian for professional help.
  • Stay hydrated: Drink plenty of water each day. Try to limit or avoid caffeine, alcohol, and carbonated beverages, which can irritate the gut.
  • Eat smaller, more frequent meals: Eating five to six small meals a day may be gentler on your gut than three large meals a day.
  • Do your best to manage stress: Although stress doesn’t cause UC, it may make your symptoms worse. Activities such as exercise, meditation, and deep breathing exercises can help ease stress.

Ulcerative Colitis Prognosis

The only definitive long-term treatment option for UC is surgery to completely remove the large intestine. However 50 percent of people with UC only experience mild to moderate symptoms, and many have only occasional flare-ups with longer periods of remission.

In up to one-third of people, the condition worsens and the symptoms become more frequent, eventually requiring surgery.

Along with medications to manage symptoms, avoiding triggers can help reduce flare-ups, which includes reducing stress.

During more active periods of the disease, making the following dietary changes can help reduce symptoms:

  • Eat smaller amounts of food throughout the day.
  • Drink plenty of water.
  • Limit insoluble fiber, a type of fiber that the body doesn’t digest and is more irritating to the gut than soluble fiber, a type of fiber that the body does digest.

  • Avoid greasy or fatty foods.
  • Limit dairy products, if you’re lactose intolerant.

Complications of Ulcerative Colitis

Without treatment, UC can lead to the following complications:

  • Severe bleeding
  • Perforated colon, or holes or tears in the colon
  • Anemia, or low red blood cell count
  • Arthritis
  • Colorectal cancer
  • Toxic megacolon, where the colon rapidly swells
  • Slowed growth and development in children

Research and Statistics: Who Has Ulcerative Colitis?

UC affects up to 900,000 people in the United States.

Symptoms of the condition typically start between ages 15 and 30, and most people receive a diagnosis in their mid-thirties. There’s also a peak in UC diagnoses between ages of 50 and 70.

White people and people of Ashkenazi Jewish descent have a higher risk of developing ulcerative colitis.

Ulcerative colitis affects men and women equally, and people with a family history are more likely to develop the condition.

Conditions Related to Ulcerative Colitis

UC is a type of IBD, but it differs from another digestive condition called irritable bowel syndrome (IBS). Although the disorders share symptoms, such as abdominal pain and diarrhea, inflammation and ulcers do not occur with IBS.

Crohn’s disease is another type of IBD that differs from UC. While UC affects the colon, Crohn’s disease can affect any part of the digestive tract.

 Common symptoms include nausea, weight loss, abdominal pain, and vomiting.

Support for Ulcerative Colitis

The Crohn’s & Colitis Foundation is the leading nonprofit organization focused on research and support for people with IBD. Their mission is to cure Crohn’s disease and ulcerative colitis and improve the quality of life of Americans living with IBD.

The Takeaway

  • Ulcerative colitis is a chronic inflammatory condition that affects the colon.
  • Symptoms include urgency, frequent bowel movements, and bloody stools.
  • While surgery to remove the colon is the only definitive long-term treatment, most people can manage the condition with medications and lifestyle adjustments.

Common Questions & Answers

Can I live a normal life with ulcerative colitis?
Similar to those with other types of IBD, most people with UC live active lives and experience long periods without symptoms. Finding the right treatment plan with your doctor can minimize flare-ups and help you live a normal life with UC.
Yes, there is a genetic risk associated with UC, but this varies in different patient populations.
Treatment by a doctor is essential when you’re experiencing a UC flare. But you can reduce discomfort at home by limiting or avoiding dietary triggers and using sanitary wipes or sitz baths to soothe a sore behind.
Ulcerative colitis can be challenging, both physically and emotionally. Symptoms such as diarrhea and abdominal pain can be frustrating and lead to frequent bathroom trips. However, seeking support and taking steps to manage flare-ups can help you cope.
Maintain a healthy diet full of lean proteins, fruits, vegetables, and soluble fiber if you have UC. Avoid anything that you’ve identified as a trigger food. If you don’t yet know what foods can trigger a flare, it might help to keep a food diary to track what you eat.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. What Is Ulcerative Colitis? Crohn’s and Colitis Foundation.
  2. Signs and Symptoms of Ulcerative Colitis. Crohn’s and Colitis Foundation.
  3. Ulcerative Colitis: Symptoms and Causes. Mayo Clinic. November 22, 2024.
  4. Ulcerative Colitis. MedlinePlus. March 31, 2024.
  5. Overview of Ulcerative Colitis. Crohn’s and Colitis Foundation.
  6. Ulcerative Colitis Treatment Options. Crohn’s and Colitis Foundation.
  7. Ulcerative Colitis: Diagnosis and Treatment. Mayo Clinic. November 22, 2024.
  8. Inflammatory Bowel Disease (IBD): Role of Fiber. American Gastroenterological Association.
  9. Definition and Facts of Ulcerative Colitis. National Institute of Diabetes and Digestive and Kidney Diseases. September 2020.
  10. IBS vs. IBD. Crohn’s and Colitis Foundation.
  11. What Is Crohn’s Disease? Crohn’s and Colitis Foundation.
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Waseem Ahmed, MD

Medical Reviewer

Waseem Ahmed, MD, is an assistant professor of medicine in the Karsh Division of Gastroenterology and Hepatology at Cedars-Sinai Medical Center in Los Angeles and serves as Director, Advanced Inflammatory Bowel Disease Fellowship and Education within the F. Widjaja Inflammatory Bowel Disease Institute.

He received his undergraduate degree from the University of Michigan and attended medical school at Indiana University. He then completed an internal medicine residency at New York University, followed by a fellowship in gastroenterology and hepatology at Indiana University, and an advanced fellowship in inflammatory bowel disease at the Jill Roberts Center for Inflammatory Bowel Disease at New York-Presbyterian Hospital/Weill Cornell Medicine. Prior to his current role, Dr. Ahmed served as an assistant professor of medicine within the Crohn’s and Colitis Center at the University of Colorado from 2021-2024.

Dr. Ahmed is passionate about providing innovative, comprehensive, and compassionate care for all patients with inflammatory bowel disease (IBD). His research interests include IBD medical education for patients, providers, and trainees; clinical trials; acute severe ulcerative colitis; and the use of combined advanced targeted therapy in high-risk IBD.

He enjoys spending time with his wife and dog, is an avid follower of professional tennis, and enjoys fine dining.

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Ingrid Strauch joined the Everyday Health editorial team in May 2015 and oversees the coverage of multiple sclerosis, migraine, macular degeneration, diabetic retinopathy, other neurological and ophthalmological diseases, and inflammatory arthritis. She is inspired by Everyday Health’s commitment to telling not just the facts about medical conditions, but also the personal stories of people living with them. She was previously the editor of Diabetes Self-Management and Arthritis Self-Management magazines.

Strauch has a bachelor’s degree in English composition and French from Beloit College in Wisconsin. In her free time, she is a literal trailblazer for Harriman State Park and leads small group hikes in the New York area.

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