Ulcerative Colitis

What is ulcerative colitis?

Ulcerative colitis is a long-term condition that affects your bowel. It causes swelling and soreness (called inflammation) in your large bowel and back passage (rectum). Small sores can form on the inside lining of your bowel, which can bleed and make pus.

Your large bowel is also called your colon. It's the part of your digestive system where your body removes water from waste before it becomes poo.

What are the main signs?

The most common signs of ulcerative colitis include:

• Loose, watery poo that keeps coming back - this might have blood, slime, or pus in it
• Tummy pain
• Needing to rush to the toilet often
• Feeling very tired all the time
• Not feeling hungry
• Losing weight without trying

How bad these signs are depends on how much of your bowel is affected and how swollen it is.

What happens during a flare-up?

Many people with ulcerative colitis have good periods (called remission) where they feel well, followed by bad periods (called flare-ups) when symptoms get much worse.

During a flare-up, you might also get:

• Painful, swollen joints
• Mouth sores
• Lumps and patches of swollen fat under your skin
• Red, sore eyes
• Weak bones

When should you speak to your GP?

See your GP as soon as possible if you have:

• Blood in your poo
• Loose poo that won't go away
• Tummy pain with frequent trips to the toilet

Get urgent help if you have:

• Severe tummy pain
• Very frequent loose poo with lots of blood
• Signs you're getting dehydrated (feeling dizzy, dry mouth, not weeing much)

If you can't reach your GP, call NHS 111 or contact your local out-of-hours service.

What causes it?

Doctors think ulcerative colitis happens when your body's defence system (immune system) gets confused. Instead of just fighting off germs, it starts attacking the healthy parts of your bowel by mistake.

We don't fully understand why this happens, but it's likely a mix of your genes and things in your environment.

Who gets ulcerative colitis?

About 1 in every 227 people in the UK has ulcerative colitis - that's around 296,000 people. It can start at any age, but most people are diagnosed between 15 and 25 years old. It affects men and women equally.

How is it treated?

Treatment aims to calm down flare-ups and keep you feeling well between them. This usually involves medicines that reduce inflammation in your bowel.

Mild flare-ups can often be managed at home with medicine. More severe flare-ups might need treatment in hospital.

If medicines don't help enough, some people need surgery to remove part or all of their large bowel.

The difference between IBD and IBS

Ulcerative colitis is a type of inflammatory bowel disease (IBD). This is different from irritable bowel syndrome (IBS), which is a separate condition that needs different treatment.

Remember, if you're worried about any symptoms, speak to your GP. They can arrange tests to find out what's causing your symptoms and get you the right help.

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Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.