Ulcerative colitis is a form of inflammatory bowel disease (IBD). The
cause is unknown. In ulcerative colitis, the immune system is
inappropriately triggered to attack the lining of the large intestine
(colon) and rectum, causing chronic inflammation. The inflammation
causes symptoms and leads to formation of open sores (ulcers) and,
eventually, loss of the lining of the colon.
Unlike Crohn’s disease,
ulcerative colitis does not affect all layers of the intestine. In
ulcerative colitis, inflammation occurs only in the top layer, but it is
continuous—meaning there are no areas of normal tissue between areas of
diseased tissue. The inflammation may be limited to the left side of the
colon (limited or distal colitis) or the rectum and lower part of the
colon (proctitis), or it may involve the entire colon (pancolitis).
Symptoms of ulcerative colitis vary in severity, although most people
with the disease will have mild to moderate symptoms. Symptoms may
subside for a while (remission) and then return (flare). The most common
symptoms are abdominal pain and bloody diarrhea. Other symptoms may
include anemia, fatigue, weight loss, and rectal bleeding.
Proper diagnosis of ulcerative colitis is important for optimal
treatment. If IBD is suspected based on symptoms, our
gastroenterologists will perform tests to confirm the presence of
intestinal inflammation and to determine whether the inflammation is due
to ulcerative colitis, Crohn’s disease, or another cause.
The first goal of treatment is to put ulcerative colitis in remission.
Remission means that inflammation is controlled and there are no
symptoms or signs of inflammation. Once remission is achieved, the goal
is to prevent further symptoms and complications (maintain remission).
Drug therapy. Advances in medical therapy are making it
possible to achieve and maintain remission. Medical treatment is
tailored to each person’s needs and varies depending on the extent and
severity of disease, response to medications, and side effect
considerations. Lankenau gastroenterologists offer expertise in
individualized treatment for ulcerative colitis using the following
Mesalamine-containing drugs (5-ASA agents)
Anti-inflammatory drugs, including corticosteroids (these may be
taken orally or applied rectally)
Biologic response modifiers (“biologics”)
Surgery. Some people with ulcerative colitis eventually
may need to undergo surgery to remove their colon. Reasons include
excessive bleeding or rupture of the colon, disease that cannot be
controlled with medications, or the presence of precancerous or
Lankenau surgeons have extensive expertise in the surgical management
ulcerative colitis. The most common procedures are:
For more information, call 1.866.CALL.MLH.