Ulcerative Colitis – Inflammatory Bowel disease

What is it?

Ulcerative Colitis (UC) is an inflammatory bowel disease (IBD) where the colon (large intestine/ bowel) and rectum (the end of the bowel) become inflamed.

Unlike Crohn’s disease, Ulcerative colitis is limited to the colon, whilst Crohn’s disease can occur anywhere between the mouth and the anus. In Crohn’s disease, there are healthy parts of the intestine mixed in between the inflamed areas

During inflammation, small ulcers may develop on the colon’s lining, which may bleed and produce pus. These can be managed through diet and lifestyle, however during acute flare-ups, medical attention may be required.

According to the NHS around 1 in every 420 people living in the UK has ulcerative colitis. This amounts to around 146,000 people.

The condition can develop at any age but is most commonly diagnosed in people aged 15-25 years old, and is rarer in people from Asian backgrounds.

Having a family member with ulcerative colitis increases your risk of developing the condition.

Symptoms of Ulcerative colitis

Potential symptoms include:

• Recurrent diarrhoea, often containing blood, mucus or pus.
• Stomach pain/ache
• A frequent need to empty your bowels.
• Extreme tiredness/ fatigue
• Weight loss and/or loss of appetite.
• During a flare-up – swollen joints or arthritic joints, mouth ulcers , irritated red eyes, swollen, red, painful skin, shortness of breath, irregular heartbeat, fever, high temperature.

What are the different types of UC?

There are five types of ulcerative colitis that are identified largely by where they are located in the body or their severity. Symptoms differ between each type of UC

1. Ulcerative Proclitis

This is usually the mildest form of UC. It is limited to the rectum and rectal bleeding may be the only sign or symptom.

2. Proctosigmonditis

This type affects the lower end of the colon along with the rectum and is sometimes called sigmoid colon. Symptoms include bloody diarrhoea, abdominal cramps and pain.

3. Left-sided colitis

This type causes cramps on the left side of the abdomen affecting the rectum and the portion of the colon on the left side of the body. Signs and symptoms include bloody diarrhoea and weight loss.

4. Pancolitis

Pancolitis can affect the entire colon, causing multiple symptoms including bloody diarrhoea, major weight loss, pain, fatigue and abdominal cramps.

5. Acute severe ulcerative colitis

This condition is rare but affects the entire colon. Symptoms include bloody diarrhoea, pain and fever.

What are the possible contributing factors?

UC is an autoimmune condition, whereby the body’s immune system, mistakenly attacks its own healthy tissue it’s cause is unknown but genetic and environmental factors such as diet and stress are thought to play a role as well as immune dysregulation.

Treatment

Your GP may arrange a stool or blood test for you to determine contributory factors causing symptoms.

Certain medicines can be used, including ASA’s (Aminosalicylates), Corticosteroids and immunosuppressants to reduce inflammation

In severe cases, surgery to remove part of the colon may be proposed and either an ileostomy takes place or an ileoanal pouch is created.

FAQ

Q1: What is ulcerative colitis?

Ulcerative colitis (UC) is an inflammatory bowel condition where the colon and rectum become inflamed. According to the NHS, around 1 in every 420 people in the UK has ulcerative colitis — approximately 146,000 people. It is most commonly diagnosed in people aged 15–25 and is more common in those with a family history of the condition.

Q2: What are the types of ulcerative colitis?

There are five types: ulcerative proctitis (limited to the rectum, usually mildest), proctosigmoiditis (lower colon and rectum), left-sided colitis (rectum and left side of colon), pancolitis (entire colon), and acute severe ulcerative colitis (rare but affects the entire colon and requires urgent medical attention).

Q3: What are the symptoms of ulcerative colitis?

Symptoms include recurrent diarrhoea (often containing blood, mucus or pus), stomach pain, frequent need to empty the bowels, extreme tiredness, weight loss, and loss of appetite. During a flare-up, additional symptoms can include swollen joints, mouth ulcers, skin problems, and fever.

Q4: How can nutritional therapy help with ulcerative colitis?

We work alongside your conventional medical team to provide nutritional therapy and functional medicine support. We focus on dietary strategies to reduce inflammation, support gut barrier function, and address nutritional deficiencies that are common in UC (such as iron, B12, vitamin D, and zinc). We do not replace medical treatment — we work as a complementary support alongside it.

Q5: Do you work alongside gastroenterologists for ulcerative colitis?

Yes. If you are already working with a gastroenterologist or therapist, we are very happy to work alongside them. We can provide nutritional therapy and functional medicine support as part of a wider care team.