Understanding Ulcerative Colitis
Ulcerative colitis is a chronic inflammatory bowel disease (IBD) in which abnormal reactions of the immune system cause inflammation and ulcers on the inner lining of the large intestine (also called the colon and includes the rectum). Ulcerative colitis can develop at any age, but the disease is more likely to develop in people before the age of 30. Men and women are equally likely to be affected, but older men are more likely to be diagnosed than older women. The risk of developing ulcerative colitis is higher in those with a family history of it. Although ulcerative colitis can affect people of any racial or ethnic group, white people and those of Ashkenazi Jewish descent have the highest risk.
Symptoms of Ulcerative Colitis
Symptoms vary based on the severity of inflammation and where it is located and include diarrhea (often with blood, mucus or pus), blood in the stool, abdominal pain and cramping, rectal pain, urgency to have a bowel movement, weight loss, fatigue, fever, and in children, failure to grow. About half of those with ulcerative colitis have mild to moderate symptoms. Some people have long periods without symptoms (called remission).
Diagnosing Ulcerative Colitis
To diagnose ulcerative colitis, a colonoscopy is performed and tissue samples from the lining of the colon are collected. Other testing may include sigmoidoscopy, blood tests, stool tests, X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans.
Treatment of Ulcerative Colitis
Treatment of ulcerative colitis includes many different drugs and classes of drugs or surgery when drugs do not control the disease. Drug choices depend on how severe the disease is and where it occurs in the colon. Treatment options include aminosalicylates (5-ASA), corticosteroids, immunomodulators, and biologic medications. Some commonly used biologics include infliximab (e.g., Inflectra®, Remicade®) administered into the blood stream intravenously, Zymfentra®, a subcutaneous infliximab formulation, golimumab (Simponi®) administered under the skin subcutaneously, guselkumab (Tremfya®), administered intravenously for induction or subcutaneously for induction and maintenance, and ustekinumab (Stelara®), given intravenously for induction and subcutaneously for maintenance.
Resources:
- Crohn’s & Colitis Foundation
- National Institute of Diabetes and Digestive and Kidney Diseases | Ulcerative Colitis
References:
Last reviewed 12/16/2025
