Ulcerative Colitis

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What is Ulcerative Colitis?

Ulcerative colitis is a chronic disease of the large intestine, also known as the colon, in which the lining of the colon becomes inflamed and develops tiny open sores, or ulcers, that produce pus and mucous. The combination of inflammation and ulceration can cause abdominal discomfort and frequent emptying of the colon.

Ulcerative colitis is the result of an abnormal response by your body’s immune system. Normally, the cells and proteins that make up the immune system protect you from infection. In people with IBD, however, the immune system mistakes food, bacteria, and other materials in the intestine for foreign or invading substances. When this happens, the body sends white blood cells into the lining of the intestines, where they produce chronic inflammation and ulcerations.

It’s important to understand the difference between ulcerative colitis and Crohn’s disease. Crohn’s disease can affect any part of the gastrointestinal (GI) tract, but ulcerative colitis affects only the colon. Additionally, while Crohn’s disease can affect all layers of the bowel wall, ulcerative colitis only affects the lining of the colon.

While both ulcerative colitis and Crohn’s disease are types of inflammatory bowel diseases (IBD), they should not be confused with irritable bowel Syndrome (IBS), a disorder that affects the muscle contractions of the colon. IBS is not characterized by intestinal inflammation.

What are the Signs and Symptoms?

About half of all patients with ulcerative colitis experience mild symptoms. Be sure to consult your doctor if you experience any of the following symptoms:

  • bowel movements become looser and more urgent
  • persistent diarrhea accompanied by abdominal pain and blood in the stool
  • stool is generally bloody
  • crampy abdominal pain

People suffering from ulcerative colitis often experience loss of appetite and may lose weight as a result. A feeling of low energy and fatigue is also common. Among younger children, ulcerative colitis may delay growth and development.

The symptoms of ulcerative colitis do tend to come and go, with fairly long periods in between flare-ups in which patients may experience no distress at all. These periods of remission can span months or even years, although symptoms do eventually return. The unpredictable course of ulcerative colitis may make it difficult for physicians to evaluate whether a particular course of treatment has been effective or not.

What are the Causes of Ulcerative Colitis? Who is Affected?

Although considerable progress has been made in IBD research, investigators do not yet know what causes this disease. Studies indicate that the inflammation in IBD involves a complex interaction of factors: the genes the person has inherited, the immune system, and something in the environment. Foreign substances (antigens) in the environment may be the direct cause of the inflammation, or they may stimulate the body’s defenses to produce an inflammation that continues without control. Researchers believe that once the IBD patient’s immune system is “turned on,” it does not know how to properly “turn off” at the right time. As a result, inflammation damages the intestine and causes the symptoms of IBD. That is why the main goal of medical therapy is to help patients regulate their immune system better.

Research sponsored by the Crohn’s & Colitis Foundation has led many scientists to believe that ulcerative colitis may be the result of an interaction of a virus or bacterial infection of the colon and your body’s natural immune system response. Normally, your immune system will cause temporary inflammation to combat an illness or infection, and then the inflammation will be reduced as you regain health. In people with ulcerative colitis, however, this inflammation can persist long after your immune system should have finished its job.

Ulcerative colitis may affect as many as 907,000 Americans. Men and women are equally likely to be affected, and most people are diagnosed in their mid-30s. The disease can occur at any age and older men are more likely to be diagnosed than older women.

While ulcerative colitis tends to run in families, researchers have been unable to establish a clear pattern of inheritance. Studies show that up to 20 percent of people with ulcerative colitis will also have a close relative with the disease. The disease is more common among white people of European origin and among people of Jewish heritage.

Source: Crohn’s & Colitis Foundation. 2018. What is Ulcerative Colitis? http://www.crohnscolitisfoundation.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis/