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Inflammatory Bowel Disease

Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory bowel disease that affects the innermost lining of the colon and rectum, causing inflammation and ulcers that produce diarrhea, urgency, and bleeding.

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Symptoms

  • Bloody diarrhea with mucus
  • Urgency and frequent bowel movements
  • Lower abdominal cramping and tenesmus
  • Fatigue, weight loss, and, in severe cases, fever

Possible causes

  • Immune-mediated inflammation in genetically susceptible individuals
  • Environmental factors; interestingly, smoking is protective (never a recommendation)
  • Family history increases risk

How we diagnose

  • Colonoscopy with biopsies confirming continuous inflammation from the rectum
  • Fecal calprotectin, CRP, and CBC for activity monitoring
  • Ruling out infectious causes with stool testing

Treatment options

  • 5-aminosalicylates (mesalamine) for mild to moderate disease
  • Biologics and small-molecule therapies for moderate to severe disease
  • Short courses of corticosteroids for flares
  • Colectomy in selected refractory or high-risk cases

Lifestyle & prevention

  • Adherence to maintenance therapy — even in remission
  • Colonoscopic surveillance for dysplasia after 8+ years of disease
  • Bone-health monitoring, especially with steroid exposure
  • Mental health support: chronic disease affects mood and vice versa