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Ulcerative Colitis

About Ulcerative Colitis

Ulcerative Colitis is a form of inflammatory bowel disease, or inflammation of the colon. It is similar to Crohn’s Disease, but tends to affect only the colon. The inflammation starts in the rectum and works backwards towards the end of the small intestine. It is associated with varying degrees of severity. While most patients with ulcerative colitis do not require surgery, it requires care of a specialized physician trained in the disease. The most common symptoms associated with ulcerative colitis include:

  • blood in the stool

  • recurring rectal discomfort, pain, or feeling of incomplete evacuation of stool

  • abdominal pain

  • diarrhea

    Ulcerative colitis can be associated with other conditions outside the intestine. These include:

  • arthritis

  • Primary Sclerosing Cholangitis (disease of the bile ducts)

  • Uveitis (inflammation in a part of the eyes)

  • Skin rashes


The diagnosis and evaluation of ulcerative colitis usually requires a colonoscopy. This test uses a colonoscope to visually examine the inside of the colon and rectum for disorders of the lining. A colonoscope is a thin, flexible tube, with a tiny fiber-optic video camera and a light inside its tip. It is about the thickness of an adult finger. The tube is flexible and can be maneuvered to investigate the interior surface of the colon. The camera sends magnified images of the colon to a television screen. Multiple biopsies or samples of tissue are usually taken to examine under the microscope. This helps your doctor determine the severity of the disease and the most appropriate treatment options.

Treatment for Ulcerative Colitis

Most patients with ulcerative colitis today do not require surgery. They are instead treated with medication that calms down your body’s inflammatory response which is the reason for the disease. There are several different types of medications including steroids (such as prednisone), oral medications (including 5-ASA agents such as mesalamine and immunomodulators such as 6-MP or azothiaprine), and intravenous or intramuscular medications called biologics that suppress your immune system (for more severe disease). Over 80% of patients with ulcerative colitis can be successfully treated using these medications. Surgery is reserved for disease that does not respond to these medications or for complications arising from disease or due to side effects from the medication. Surgery offers a complete cure for ulcerative colitis should it become necessary.

Surgery involves complete removal of the colon and rectum. Usually, the small intestine is then folded into a “J-pouch” and reconnected to the anus. This surgery usually requires a temporary bag to divert the stool, but once everything has healed, it can be reversed. Patients can learn to function with this new configuration and often lead normal lives. Some patients may also qualify for a minimally invasive approach to this kind of pouch surgery. To learn more, contact one of our specialized physicians at USC.

For more information, visit the American Society of Colon and Rectal Surgeons website.

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