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What is Ulcerative Colitis & How is it Caused?

What is Ulcerative Colitis?

Inflammatory bowel disease (IBD) is known as ulcerative colitis. This condition causes long-term inflammation in the area of the digestive tract. Just like Crohn’s disease, which is another common IBD, ulcerative colitis can be incapacitating and may also result in life-threatening complications. Ulcerative colitis is a chronic condition, due to which symptoms develop gradually, rather than abruptly. The innermost lining of the large intestine, i.e. colon, and rectum are commonly affected by ulcerative colitis. Whereas, Crohn’s disease, can occur anywhere in the digestive tract and may usually spread deep into the tissues.

Ulcerative Colitis or Colitis Ulcerosa

How is Ulcerative Colitis Caused?

Ulcerative colitis is a serious medical condition which weakens the body and can result into complications which can be life threatening. Currently there is no cure for ulcerative colitis available however; the signs and symptoms can be reduced significantly with treatment.

The causes for the occurrence of ulcerative colitis are still a mystery. Earlier it was believed that improper diet and stress caused ulcerative colitis but it was proved that these factors could only make you prone to this condition. The issues with the immune system are considered a major cause.

Ulcerative Colitis Caused Due to Autoimmune Condition

Autoimmune conditions can cause ulcerative colitis. The immune system is meant to protect body by fighting against harmful foreign bodies but sometimes in some cases during autoimmune condition, it can start damaging the healthy tissues of the body.

In case of any infection in the body, the white blood cells count is increased by immune system to fight against the cause of infection. This often leads to swelling with inflammation particularly in the affected area of the body.

As per the best theory available, in case of ulcerative colitis the immune system starts to attack the “friendly bacteria” identifying it as infection causing inflammation in rectum and colon. These bacteria help in digestion of food.

According to some other theories, the situation is a result of a situation where immune system continues to fight once triggered by infection even the infection has been treated.

Sometimes any malfunctioning of the immune system or any disturbance of the balance between the bad and good bacteria can also be responsible for the condition of the ulcerative colitis.

Genetics Can Cause Ulcerative Colitis

Genes are also supposed to play a major role as almost 25 percent of the cases of ulcerative colitis have been found to be individuals having family history for ulcerative colitis. In addition, some of the ethnic groups have been seen to be more affected by this issue.

There are certain genes, which have been recognized by researchers related to the cause of ulcerative colitis, and these genes are closely related to the immune system.

Ulcerative Colitis Caused Due to Environmental Factors

Certainly environmental conditions also seem to influence the cause or occurrence of the ulcerative colitis reflecting the role of environmental factors. For example, there are high cases of ulcerative colitis in the particularly northern areas of America and Western Europe.

Researchers have studied various environmental factors like air pollution, diets, medication etc… to determine the relation with the occurrence or cause of ulcerative colitis. The researchers are still not sure about any particular factor but they have found higher cases of ulcerative colitis in the highly populated countries with good sanitary conditions. This makes us believe that less exposure to the bacteria is also one of the major causes.

Tests to Diagnose Ulcerative Colitis

Doctors and other health experts usually first check for other causes that may lead to the signs and symptoms of ulcerative colitis and other medical conditions such as crohn’s disease, ischemic colitis, infection, diverticulitis, irritable bowel syndrome (IBS) and colon cancer should be ruled out.

Specialists will test to diagnose ulcerative colitis once other illnesses are ruled out. Some of the specific tests and procedures are described below:

  • In the physical exam for ulcerative colitis the general physician starts by looking at the symptoms and signs of the ulcerative colitis and gather information about any medical history and general heath. General physician usually check for paleness in body that may be caused by anemia and any signs of inflammation in the tummy.
  • Blood tests are done to check for infection or anemia in ulcerative colitis. Blood tests also help in detecting the presence of certain antibodies which may help in diagnosing the type of inflammatory bowel disease.
  • Stool sample is taken to diagnose ulcerative colitis. If there are white blood cells present in the stool, then it is an indication of an inflammatory disease such as ulcerative colitis. A stool sample also helps in ruling out other disorders which are caused by bacteria, viruses and parasites. Presence of bowel infection can also be detected which is commonly found in patients suffering with ulcerative colitis or colitis ulcerosa.
  • Colonoscopy for diagnosing ulcerative colitis involves examination of the colon from inside using a highly flexible tube equipped with camera known as colonoscope. It takes about half an hour for test during which the individual does not feel any pain because of the sedatives and painkillers injected in the body. Also laxatives are used to ensure that colon is completely empty. The above procedure may also involve extracting a small tissue that is tested and analyzed in the laboratory for diagnosis of ulcerative colitis. It is called biopsy.
  • Flexible sigmoidoscopy test is also conducted for ulcerative colitis. Bowel inflammation is also a clear indication whole level can be analyzed for diagnosing ulcerative colitis. It consists of a 15 minute’s procedure in which sigmoidoscope is inserted into the rectum for analysis. Sigmoidoscope is small flexible tube equipped with camera. It can also be used to obtain a small tissue from rectum for analysis in lab. The procedure can be painful but sedatives can used to make it comfortable. Sigmoidoscopy involves analysis of only the lower part of the colon and rectum as if the infection is serious then other methods is used for further examination.

Apart from the tests mentioned above, following tests can also be conducted to diagnose ulcerative colitis:

  • Computed tomography (CT) enterography and magnetic resonance (MR) enterography for ulcerative colitis. These tests are very comfortable as they are non invasive in nature, They are very effective in detecting inflammation as compared to other similar techniques like imaging tests. MR enterography is also free from radiations.
  • Chromoendoscopy test for ulcerative colitis is particularly used to find out any cases of colorectal cancer, which is the worst case of ulcerative colitis. It involves the use of a dye to identify the presence of abnormal tissues.

Complications in Ulcerative Colitis

There are several complications in ulcerative colitis. Ulcerative colitis makes you more prone to the colon cancer. Thus doctors generally check for this during diagnoses using colonoscopy. Once diagnosed with ulcerative colitis, it is recommended to go for screening after eight to 12 months to check for any risk of colon cancer. This must be followed by one more screening after two years or so. The regular screen helps in detecting any precancerous cell formation in the early stages.

Ulcerative colitis can also be associated with one or more of the following complications:

  • Firstly, the problem results in broadening of the walls of intestine.
  • Secondly, patient may suffer from ankylosing spondylitis in which inflammation happens between e joints of spinal bones.
  • Another complication of ulcerative colitis is that patients face sepsis or infection of blood.
  • In addition, ulcerative colitis causes complication in lack of water circulation in body.
  • Toxic mega colon (frequent swelling of colon) is a complication of ulcerative colitis
  • Even the patient deals with a problem of development of opening in colon.
  • Diseases of liver disease (it is rare).
  • Furthermore, individuals with ulcerative colitis face the complication of bleeding in intestines.
  • Formation of stones in kidney leading to further complications in ulcerative colitis.
  • Other than this, patients of ulcerative colitis will experience the feeling of inflammation in particular areas like eyes, joints and skin.


  1. Mayo Clinic. (2021). Ulcerative Colitis. Mayo Clinic. Link
  2. Crohn’s & Colitis Foundation. (2021). What is Ulcerative Colitis? Crohn’s & Colitis Foundation. Link
  3. National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Ulcerative Colitis. NIDDK. Link

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 29, 2023

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