Ulcerative Colitis: Understanding the Physical and Emotional Pain

Ulcerative colitis is an inflammatory bowel disease (IBD) that causes inflammation of the digestive tract, usually the large intestine (colon) and rectum.  While the condition can strike people of any age, it usually starts between the ages of 15 and 30 and affects men and women equally.

Although there are no definitive known causes of ulcerative colitis, some scientists think the problem may be the result of an abnormal autoimmune reaction to bacteria in the digestive tract. Heredity may play a role as well since you're more likely to develop the disorder if you have a parent or sibling with the disease. What doesn't seem to trigger ulcerative colitis is stress, although stress can exacerbate symptoms.

Symptoms of Ulcerative Colitis

The most common symptoms of ulcerative colitis are stomach pain and bloody diarrhea. Other symptoms may include:

  • Anemia
  • Fatigue
  • Weight loss
  • Loss of appetite
  • Rectal bleeding
  • Loss of body fluids and nutrients
  • Skin lesions
  • Joint pain

Be sure to see your doctor if you have a persistent change in your bowel habits or if you experience any one of the following:

  • Abdominal pain
  • Blood in your stool
  • Ongoing bouts of diarrhea that don't respond to over-the-counter medications
  • An unexplained fever lasting more than a day or two

Tests and Diagnosis

In addition to giving you a physical exam and taking your medical history, your doctor may also prescribe a number of tests to confirm a diagnosis of ulcerative colitis. Some tests include:

  • Blood tests to check for anemia or infection.
  • Stool sample to look for the presence of white blood cells, which can indicate an inflammatory disease. A stool sample can also help rule out other disorders.
  • Colonoscopy exam to view your entire colon and extract a small tissue sample to confirm a diagnosis.
  • X-ray or CT scan to help diagnose ulcerative colitis or determine its complications.


Although there's no cure for ulcerative colitis, there are several categories of drugs that control inflammation and alleviate symptoms. Surgery is also an option for people whose disease can't be controlled by lifestyle changes or drug therapy. Because the severity of disease varies from person to person, your doctor will determine which treatment plan is best for you. Some types of drugs include:

  • Anti-inflammatory drugs. These drugs are often used first and include sulfasalazine, mesalamine, balsalazide, olsalazine and corticosteroids
  • Immune system suppressors. These drugs also reduce inflammation. They include azathioprine, mercaptopurine, cyclosporine, infliximab

Your doctor may prescribe other medications such as antibiotics, anti-diarrheals, pain relievers or iron supplements.

While diet doesn't appear to cause ulcerative disease, what you eat may aggravate your symptoms. Keeping a food diary and eliminating any foods from your diet that cause you problems may help reduce symptoms.