Ulcerative Colitis: Symptoms and Treatments
Fact sheet on ulcerative colitis

Ulcerative colitis is a disease characterized by inflammation and sores, called ulcers, in the lining of the rectum and colon. Ulcers form where inflammation has killed the cells that usually line the colon. This leads to inflammation, bleeding, and pus. Inflammation in the colon also causes the colon to empty frequently, causing diarrhea.
Ulcerative colitis is an inflammatory bowel disease. This is the general name for diseases that cause inflammation in the small intestine and colon. It can be difficult to diagnose because its symptoms are similar to other intestinal disorders such as Crohn’s disease. Crohn’s disease differs because it causes inflammation deeper within the intestinal wall and can occur in other parts of the digestive system.
Ulcerative colitis may occur in people of any age, but it usually starts between the ages of 15 and 30, and less frequently between 50 and 70 years of age. The disease affects men and women equally and appears to run in families; up to twenty percent of those affected have a family member with ulcerative colitis or Crohn’s disease.
The symptoms of ulcerative colitis
The most common symptoms of ulcerative colitis are abdominal pain and bloody diarrhea. Patients also may experience anemia, fatigue, weight loss, loss of appetite, rectal bleeding, loss of body fluids and nutrients, skin lesions, joint pain, and growth failure.
Approximately half of the people diagnosed with ulcerative colitis experience mild symptoms while others suffer frequent fevers, bloody diarrhea, nausea, and severe abdominal cramps. Ulcerative colitis may also cause problems such as arthritis, inflammation of the eye, liver disease, and osteoporosis.
People with ulcerative colitis have abnormalities of the immune system, but it is unclear whether these abnormalities cause or result from the disease. Although ulcerative colitis is not caused by emotional distress or indigestion, these factors may trigger symptoms in some people. Treatment for ulcerative colitis depends on the severity of the disease.
Drug Therapy
The goal of drug therapy for ulcerative colitis is to keep symptoms at bay and provide the patients with relief.
Aminosalicylates are drugs that contain 5-aminosalicyclic acid (5-ASA), help control inflammation. Sulfasalazine is a combination of sulfapyridine and 5-ASA. The sulfapyridine component carries the anti-inflammatory 5-ASA to the intestine. However, sulfapyridine may lead to side effects such as nausea, vomiting, heartburn, diarrhea, and headache.

Corticosteroids such as prednisone, methylprednisone, and hydrocortisone also reduce inflammation and are another option for ulcerative colitis treatment. They may be used by those who do not respond to 5-ASA drugs. These drugs can cause side effects such as weight gain, acne, facial hair, hypertension, diabetes, mood swings, bone mass loss, and an increased risk of infection.
Immunomodulators such as azathioprine and 6-mercapto-purine (6-MP) reduce inflammation by affecting the immune system. These drugs are used for patients who have not responded to 5-ASAs or corticosteroids and are administered orally, however, they are slow-acting and it may take up to 6 months before the full benefit.