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What Is Ulcerative Colitis? How Do I Know if I Have It?

Image of What Is Ulcerative Colitis? How Do I Know if I Have It?
Image of What Is Ulcerative Colitis? How Do I Know if I Have It?

After suffering with your gastrointestinal symptoms for as long as you could, you’ve finally decided to put in some serious research to figure out what’s going on with you. Or maybe you’ve already been to a doctor who told you ulcerative colitis could be the problem.

No matter where you are in your GI health journey, we’re guessing you’re here because you suspect ulcerative colitis could be the root of your digestive distress (to put it mildly). And while only a doctor can give you a real diagnosis, we know that the more knowledge you have, the easier it’ll be to take the right next steps.

What is ulcerative colitis?

You’ve probably heard of inflammatory bowel disease, but did you know it’s actually an umbrella term for multiple conditions? They’re all characterized by chronic inflammation of the digestive tract (the path food follows through your body), and ulcerative colitis is one of them.

So what makes ulcerative colitis unique? Well, let’s break it down. “Colitis” refers to the condition’s main target, your colon (a.k.a. large intestine), although your rectum might be affected too. “Ulcerative” means that the damage is so extensive it can cause ulcers (a.k.a. sores) in the lining of your intestines.

Ulcerative colitis is an autoimmune disease, which means your own immune system is what’s actually damaging your colon. Experts don’t know why that happens to some people and not others, and there’s no cure. But that doesn’t mean there’s no way to manage the condition—we’ll get to that in a bit.

How do I know if I have ulcerative colitis?

Apart from the ulcers, the symptoms of ulcerative colitis can look a lot like many other gastrointestinal conditions, including other types of IBD as well as irritable bowel syndrome. So how do you know when you have UC?

One key sign is whether or not any of your relatives have it. You don’t need to be related to someone with ulcerative colitis to develop it, but it does tend to run in families. Another potential clue is your age: the condition can start at any time, but most people are under 30 when they get it.

In addition to those risk factors, keep an eye out for these symptoms:

  • Abdominal pain
  • Diarrhea, sometimes with blood or mucus
  • Fatigue
  • Fevers
  • Joint pain
  • Loss of appetite
  • Rectal bleeding, pain, or urgently needing to defecate
  • Sores on your skin
  • Ulcers in the lining of the colon
  • Weight loss

Keep in mind that ulcerative colitis symptoms sometimes disappear for a few months or even years (doctors call this going “into remission”), but that doesn’t mean they’re gone for good. So even if you aren’t always experiencing these symptoms, if they’re frequent enough to be interfering with your life, you may still have UC.

How is ulcerative colitis diagnosed?

The only way your doctor can be certain you have ulcerative colitis is by performing a colonoscopy and tissue biopsy. A colonoscopy is a procedure in which your doctor inserts a long, flexible tube called a colonoscope into your (ahem) rear end. The tube is topped with a tiny camera so they can look for signs of inflammation or damage. At the same time, they’ll extract a small tissue sample from your colon to analyze—that’s the biopsy.

If the results of that test are inconclusive, your doctor may request additional tests to help confirm the diagnosis or get more information about your symptoms. That could be a stool test, a blood test, or imaging.

How do I treat ulcerative colitis?

The good news is that you don’t have to just resign yourself to a life of constant symptoms when you have UC. There are plenty of effective treatments for ulcerative colitis, including medication and diet changes.

Dietary changes

If you came here wondering which types of foods trigger ulcerative colitis, you should know that there’s no magic diet that will make your symptoms disappear. That said, you can help ease your symptoms by making some changes to how you eat, such as avoiding carbonated drinks, dairy, and high-fiber foods (think: popcorn, nuts, and vegetables with the skin on), drinking more water, and breaking up your eating schedule into smaller meals throughout the day. These same dietary tweaks can also help ease your symptoms during a flare-up.

Keeping a food diary that tracks everything you eat and how it makes you feel can help you identify what’s causing or worsening your symptoms. If you need to avoid foods that are essential for good nutrition, you can consider using supplements to make up for any nutrients you’re not getting, like iron or vitamin D.

Medication

Unfortunately, you can’t manage ulcerative colitis just by changing your diet—no matter how well you eat, you still need to treat the inflammation in your colon. According to the Crohn's & Colitis Foundation, there are six main types of medication used to treat ulcerative colitis. Which one is best for you is going to depend on a lot of factors, including the health of your immune system (because many of these medications suppress it to reduce inflammation) and whether or not you’re willing to try—or have access to—newer treatments like biologics and biosimilars.

On the other hand, some medications are better to steer clear of when you have UC. “Patients with ulcerative colitis should avoid non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, Advil, Motrin, and naproxen,” recommends Evens Medical Director and gastroenterologist Dr. Heather Gerst, “as these can make the condition worse.”

Of course, the best person to talk over your options with is your doctor.

Surgery

Before you start to worry, we should mention that most people with ulcerative colitis don’t end up needing surgery. But if lifestyle modifications and medication don’t produce enough of an improvement on their own, you might need surgical intervention to prevent really serious damage to your body (and your quality of life).

Depending on the progress of your condition, you have multiple surgical options, including removal of the colon and rectum. Clearly, these are serious interventions meant for advanced cases of ulcerative colitis, so you’ll likely have had multiple conversations with your healthcare provider before heading down this route.

What happens if my ulcerative colitis goes untreated?

Now for the opposite scenario—what if you never talk to your doctor and just don’t treat your ulcerative colitis? Well, we shouldn’t have to tell you that ignoring a problem doesn’t make it go away: Just think about that familiar image of the ostrich with its head in the sand.

Not treating ulcerative colitis can cause serious long-term health problems, including ulcers in the colon, colon infections, kidney stones, osteoporosis, and even colon cancer. That’s why it’s so important to be smarter than that ostrich—keep your head out of the sand, pay attention to your symptoms, and reach out to a doctor if new ones appear or the ones you have suddenly get worse.


It’s okay to admit that realizing (or even just suspecting) you have ulcerative colitis can be a little intimidating. After all, there’s no cure and the condition can have pretty serious health implications.

But that doesn’t mean you have to just sit back and let your condition take over your life. You can put yourself back in control by proactively reaching out to your doctor about your symptoms and potential treatment options. Treating ulcerative colitis is a lifelong journey, and the more you know about the road ahead of you, the better prepared you’ll be to find the best route for you.


The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.