Ulcerative Colitis

What is ulcerative colitis?

Ulcerative colitis is an inflammation of the lining of the large bowel (colon and rectum). The main symptom of having active disease is constant, unrelenting diarrhea with bleeding and abdominal pain in the moderate to severe stages.  Ulcerative colitis goes through periods of mild to intense activity with periods of possible remission or "quiet" stages.  In addition, patients who have had extensive ulcerative colitis for many years are at an increased risk of developing colon cancer. The cause of ulcerative colitis remains unknown.

What is involved in the treatment of ulcerative colitis?

The first step in treating ulcerative colitis is correctly identifying and diagnosing it properly.  Most people with ulcerative colitis may have lived with the disease for years and only seek treatment once their symptoms worsen.  Diagnosis involves observing the lining of the colon with a fiber-optic camera and taking pinpoint biopsies to confirm the presence of the disease.  This easy test is the "gold-standard" in diagnosing ulcerative colitis as well as making sure the patient has not developed cancer from allowing the disease to remain undiagnosed for a period of time.  Once a diagnosis has been established treatment is implemented immediately with medicines designed to decrease the inflammation present and allow the colon to heal.  As the colon is allowed to heal the patient's symptoms such as diarrhea, bleeding, or abdominal pain slowly and eventually resolve.

In order to maintain control of the disease, the patient may have to use certain medications on a long-term basis.  "Flare-ups" of the disease can often be treated by increasing the dosage of medications or adding new medications.  For severe exacerbations of the disease, hospitalization may be necessary to put the bowel to rest and deliver steroids directly into the blood stream.

Is surgery ever necessary?

Surgery is indicated for patients who have life-threatening complications of inflammatory bowel diseases, such as massive bleeding, perforation, or infection. It may also be necessary for those who have the chronic form of the disease, which fails to improve with medical therapy. It is important the patient be comfortable that all reasonable medical therapy has been attempted prior to considering surgical therapy. In addition, patients who have long-standing ulcerative colitis may be candidates for removal of the large bowel, because of the increased risk of developing cancer. More often, these patients are followed carefully with repeated colonoscopy and biopsy, and surgery is recommended only if precancerous signs are identified.


The first step in treating the cause of your diarrhea, bleeding or abdominal pain is speaking with a colorectal specialist who can accurately diagnose your problem.  Call 614-921-8686 to schedule an appointment.