Miss Patricia Boorman

Consultant Colorectal Surgeon


Ulcerative Colitis

Ulcerative colitis is a long-term condition where the colon and rectum become inflamed.

Ulcerative Colitis is a condition that causes inflammation and ulceration of the inner lining of the rectum and colon (the large bowel).

In Ulcerative Colitis, ulcers develop on the surface of the lining and these may bleed and produce mucus.

The inflammation usually begins in the rectum and lower colon, but it may affect the entire colon. If Ulcerative Colitis only affects the rectum, it is called proctitis, while if it affects the whole colon it may be called total colitis or pancolitis.

It’s one of the two main forms of Inflammatory Bowel Disease (IBD). The other is Crohn’s Disease.

Ulcerative Colitis is a chronic condition. This means that it is ongoing and lifelong, although you may have long periods of good health known as remission, as well relapses or flare-ups when your symptoms are more active. 

What are the symptoms?

Ulcerative Colitis is a very individual condition and its symptoms will vary from person to person. They range from mild to severe and may also change over time.

Some people remain well for a long time, while others have frequent flare-ups. The most common symptoms are:

  • Diarrhoea
  • Cramping pains in the abdomen
  • Tiredness and fatigue
  • Feeling generally unwell or feverish
  • Loss of appetite and weight loss
  • Anaemia (a reduced level of red blood cells).

Who gets Ulcerative Colitis?

It’s estimated that Ulcerative Colitis affects about one in every 420 people in the UK (roughly 146,000 people).

Ulcerative Colitis is more common in urban areas and in northern developed countries, although we’re starting to see an increase in numbers in developing nations, too.

Ulcerative Colitis is also more common in white Europeans, especially those of Ashkenazi Jewish descent (those who lived in Eastern Europe and Russia). 

It can start at any age, though it often appears for the first time between the ages of 15 and 25. It affects men and women equally.

Ulcerative Colitis tends to develop more frequently in non-smokers and ex-smokers than in smokers – but health professionals strongly advise against smoking as a way of treating Ulcerative Colitis.

Did you know?

That most people with Ulcerative Colitis are not diagnosed with the disease until they reach their late 20s or early 30s?

Some of these people have one or more close family members who also have ulcerative colitis, though many people are diagnosed without a known family history of the disease.

Other people at increase risk of the disease include Caucasians and people of Ashkenazi Jewish descent.

What are the causes & is there a cure?

Although there has been a lot of research, we still don’t really know what causes Ulcerative Colitis.  However, advances have been made in recent years, particularly in genetics. We now believe that Ulcerative Colitis is caused by a combination of factors:

- the genes you’re born with
- plus an abnormal reaction of the digestive system to bacteria in the intestine
- along with an unknown 'trigger' that could include viruses, other bacteria, diet, stress, or something else in the environment.

At the moment there is no cure for Ulcerative Colitis, but drugs, and sometimes surgery, can give long periods of relief from symptoms.

What treatments are there for Ulcerative Colitis?

Ulcerative Colitis can often be managed by medication (drug treatment). If your quality of life has been affected by repeated flare-ups and you have not responded well to medication, you may be advised to consider surgery.

Your treatment will depend on the type and severity of your Ulcerative Colitis and the choices you make with your doctor.

Can Ulcerative Colitis have complications?

More than a third of people with Ulcerative Colitis develop other conditions outside of the digestive system, mainly affecting the joints, eyes and skin.

Inflammation of the joints (arthritis) affects about one out of 10 people with Ulcerative Colitis. Some people with Ulcerative Colitis also develop ankylosing spondylitis, a condition in which the joints in the spine and pelvis become inflamed and stiff. Drugs and physiotherapy are used to treat these symptoms.

A variety of other health conditions can be associated with Ulcerative Colitis, including:

  • skin problems, such as mouth ulcers, blisters and ulcers on the skin, and painful red swellings, usually on the legs
  • inflammation of the eyes
  • thinner and weaker bones
  • liver inflammation
  • blood clots (including deep vein thrombosis)
  • anaemia.

If you have had extensive or total colitis (pancolitis) for many years, you have a slightly greater risk than normal of developing cancer in the colon or rectum.

However, the overall number of people with IBD who develop bowel cancer is very small, and cancers can be more successfully treated if detected early. 

Book a consultation with Miss Boorman today.