A woman sitting down and clutching her stomach.
There are no definite causes of ulcerative colitis, but lifestyle and environmental factors may play a part.

Possible Ulcerative Colitis Causes

Ulcerative colitis is a chronic digestive disorder that causes a variety of symptoms. It can also lead to some potentially life-threatening complications. But what are ulcerative colitis causes and how can it be treated? Here’s all you need to know.

What Is Ulcerative Colitis?

Ulcerative colitis is a condition that involves inflammation of the large intestine, also known as the colon. It can also affect the rectum, the lower section of the intestine where stools are stored. When the colon becomes inflamed, small ulcers form on its lining. These ulcers can bleed or exude pus.

The symptoms of ulcerative colitis may be:

  • Frequent or urgent bowel movements
  • Chronic diarrhea
  • Blood, pus, or mucus in the stools
  • Abdominal pain
  • Fatigue
  • Appetite loss
  • Weight loss

These symptoms vary in severity, with most people falling into the mild or moderate category. In severe cases, people with ulcerative colitis may pass over six bowel movements each day. Some people may also experience additional symptoms throughout the body, such as:

  • Joint swelling and pain
  • Skin rashes
  • Red or irritated eyes
  • Fever
  • Shortness of breath
  • Irregular heartbeat

Ulcerative colitis symptoms tend to follow a relapsing and remitting pattern. This means that patients may experience periods with very mild or no symptoms, interspersed with more severe flare-ups.

What Causes Ulcerative Colitis?

Most experts agree that ulcerative colitis is an autoimmune disorder. This means that the immune system becomes overactive and begins to attack healthy tissues, leading to inflammation.

It is unclear exactly why this happens in ulcerative colitis. One theory is that the immune system fails to switch off following a bacterial or viral infection. Another is that immune cells become confused and begin to attack harmless bacteria that live inside the gut.

It appears that a combination of genetic and environmental factors makes some people more prone to developing ulcerative colitis than others. For example, those with a family history of the disease are more likely to develop it themselves. Furthermore, people from certain ethnic groups are more likely to be affected than others. They include people of European descent, especially Ashkenazi Jews and African-Americans.

Lifestyle factors such as diet and stress do not cause ulcerative colitis. However, they can play a role in triggering flare-ups and increasing the severity of symptoms.

Ulcerative Colitis Prevention

Unfortunately, there is no reliable way to prevent ulcerative colitis. However, it may be possible to reduce the risk of flare-ups and extend periods of remission.

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Diet Changes

Many people with ulcerative colitis find that eating little and often helps to reduce the severity of their symptoms. For example, having five to six small meals each day, rather than three large ones.

Certain foods may also exacerbate symptoms and should, therefore, be avoided. It may be helpful to keep a diet diary for several weeks to try and identify any trigger foods. During flare-ups, patients may wish to stick to a low-fiber diet, although they should discuss this with a healthcare professional first.

Take Supplements

It is also essential to try and reduce the risk of complications. For example, prolonged diarrhea can lead to dehydration and nutritional deficiencies, like anemia. Therefore, patients should take supplements if necessary and drink plenty of fluids throughout the day. However, they should avoid caffeine, alcohol and carbonated beverages, which could make their symptoms worse.

Get Regular Check-Ups

People with ulcerative colitis also have an increased risk of bowel cancer and a condition called primary sclerosing cholangitis (damaged bile ducts). Therefore, they should attend regular screenings to check for these issues.

What Are the Treatment Options?

Ulcerative colitis treatments fall into two categories: medication to reduce inflammation and promote healing, and medication to manage symptoms. Surgery may also be necessary in some cases.


5-aminosalicylates are the most common medicines for treating ulcerative colitis. They include drugs like mesalamine and sulfasalazine. Patients can use these medications orally or as a suppository or enema, depending on the severity of their symptoms. These drugs are anti-inflammatory and are usually taken long-term to maintain remission and prevent flare-ups. Side effects that can be present:

  • Headaches
  • Nausea
  • Abdominal pain
  • Rashes
  • Diarrhea


Corticosteroids, such as prednisolone, are another type of anti-inflammatory drug that is used to manage flare-ups. Like 5-aminosalicylates, they can be administered orally or rectally. These medicines are unsuitable for long-term use due to their side effects, including osteoporosis and cataracts. Short-term side effects may be:

  • Acne
  • Increased appetite
  • Weight gain
  • Mood changes
  • Insomnia


Immunosuppressants reduce inflammation by dampening the immune response. Therefore, they can increase the risk of infections and are generally prescribed when other treatments have not worked. Other side effects vary depending on the drug, but anemia is a common issue and patients on immunosuppressants should have regular blood tests. They are usually given by injection.


Patients can manage symptoms like abdominal pain by taking acetaminophen. People with ulcerative colitis should not take non-steroidal, anti-inflammatory drugs like aspirin, ibuprofen, naproxen, or diclofenac, as they can exacerbate symptoms.

Anti-Diarrhea Medication

Patients with severe diarrhea can take anti-diarrhea drugs, such as loperamide, to manage this symptom.


Antibiotics can help to prevent and treat bacterial infections that may arise as a result of ulcerative colitis.


In severe cases, surgery to remove the colon may be necessary. This might involve connecting the small intestine to a pouch outside the body, known as an ileostomy. Alternatively, the surgeon may attach the small intestine to the anus. This procedure can cause the stools to become watery and may lead to incontinence. The best option will depend upon several factors, including the patient’s age, lifestyle, severity of symptoms and overall expectations.