The Must-Know Facts About Ulcerative Colitis

by Dr. Edward Group DC, NP, DACBN, DCBCN, DABFM Published on , Last Updated on September 3, 2014


Belonging to the same group of disorders as irritable bowel disease (IBD), ulcerative colitis is a painful condition that primarily affects the colon and rectum. Early identification can help reduce complications and offers the best chance for successful management. The flip side — not taking care of the issue — can prove fatal.

The following facts provide the information necessary for identifying ulcerative colitis, recognizing its potential complications, and understanding the therapeutic approaches available for management.

What Is Ulcerative Colitis?

Like many bowel diseases, ulcerative colitis is a chronic, inflammatory autoimmune disease that causes open sores on the colon wall. Risk factors include family history, bacterial infections, and living in modern, industrialized nations at higher latitudes. [1] It affects young adults the most and also young children. For many, the disease is a life-long battle and fewer than 50% of patients achieve long-term remission. [2]

How It Works: A Current Understanding

The exact cause of ulcerative colitis isn’t understood, but research has identified immune cell penetration of the colon wall as a cause of inflammation. [3] Certain chemicals released by intestinal cells and bacteria stimulate cell receptors that trigger an immune response (inflammation). [4] Continued inflammation of the colon wall reduces mucus production which leads to tissue damage in the form of sores or ulcers. [5]

The Causes of Ulcerative Colitis

Diet, genetics, and stress top the list of causes believed to trigger ulcerative colitis. [6] Other factors may include:

Hydrogen Sulfide Buildup

Patients with ulcerative colitis report fecal hydrogen sulfide levels four times than that of normal feces. [7] Toxic gas which may play a role in the formation of ulcers and researchers suggest the sulfate-reducing bacteria themselves reflect a overall intestinal problems and imbalance.

Dietary Triggers

One particular case of ulcerative colitis involved a man reporting intestinal pain and severe bloody diarrhea. Each instance occurred after the use of a weight loss supplement. [8] The case study could not identify whether the weight loss supplement caused the ulcers or exacerbated a pre-existing condition.

Harmful Organisms

A study from Mexico found intestinal infestation by protozoa in 24% of ulcerative colitis patients. These patients also experienced reduced effectiveness from conventional treatments. [9] A similar study looked at 31 patients with amoeba infestation. Researchers determined the presence of amoeba did not play a role in the severity of the disease, although ulcers in the colon did appear related. [10]

Symptoms of Ulcerative Colitis

Typical symptoms include bloody diarrhea and abdominal pain. As the condition worsens, the amount of blood increases and bowel movements may become painful and include abdominal cramping. [11] Anemia, fever, and weight loss may occur, all of which are also symptoms of Crohn’s disease.

Ulcerative Colitis and Intestinal Complications

Patients with IBD, like ulcerative colitis and Crohn’s disease, often experience iron-deficiency anemia and osteoporosis. These symptoms may result from the disease itself or its treatment. [12] Inflammation extends to other organs in 40% of patients, while others experience eye swelling. [13] Some patients experience problems with deep vein thrombosis and pulmonary embolism. [14] In extreme cases, colon swelling, hemorrhaging, and perforation can also result. [15] [16]

The Advanced Risks of Ulcerative Colitis

On top of the many serious complications of the disease, ulcerative colitis can develop into even more concerning issues, including:


With increased risk of blood clots, the risk for blood clots in the brain also increases. One recent case involved a patient who experienced an arterial stroke as a result of his ulcerative colitis. [17] Inflammation and internal bleeding can increase chances of developing blood clots. Genetics can impact clotting tendencies that further exacerbate the condition.

Colon Cancer

The breakdown of the mucus layer along with chronic internal swelling can contribute to cancerous lesions. Researchers speculate the increased turnover of cells in affected areas may contribute to colorectal cancer formation. The intestinal bacterial environment may also affect cellular response which may trigger and stimulate cancer cell growth. [18] [19]

Natural Management

We’re continuing to find effective and safe management options for ulcerative colitis and many researchers are looking to natural compounds. Probiotic therapy is just one of the many avenues currently being explored, and acupuncture and herbal therapies are also part of the conversation. Until then, it is always best to eat a healthy, easy-to-digest diet.

Do you have ulcerative colitis? How do you manage? Share your experience with us and leave a comment!


  1. Adams SM, Bornemann PH. Ulcerative colitis. Am Fam Physician. 2013 May 15;87(10):699-705.
  2. Torres J, Danese S, Colombel JF. New therapeutic avenues in ulcerative colitis: thinking out of the box. Gut. 2013 Nov;62(11):1642-52. doi: 10.1136/gutjnl-2012-303959.
  3. Ko IK, Kim BG, Awadallah A, Mikulan J, Lin P, Letterio JJ, Dennis JE. Targeting improves MSC treatment of inflammatory bowel disease. Mol Ther. 2010 Jul;18(7):1365-72. doi: 10.1038/mt.2010.54.
  4. Szumilas D, Krysiak R, Okopie B. The role of TLR4 receptor in development of inflammation and carcinogenesis in ulcerative colitis and pharmacotherapy of this disorder. Wiad Lek. 2013;66(1):3-9.
  5. Andersen V, Olsen A, Carbonnel F, Tjønneland A, Vogel U. Diet and risk of inflammatory bowel disease. Dig Liver Dis. 2012 Mar;44(3):185-94. doi: 10.1016/j.dld.2011.10.001.
  6. Dorofeyev AE, Vasilenko IV, Rassokhina OA, Kondratiuk RB. Mucosal barrier in ulcerative colitis and Crohn’s disease. Gastroenterol Res Pract. 2013;2013:431231. doi: 10.1155/2013/431231.
  7. Levine J, Ellis CJ, Furne JK, Springfield J, Levitt MD. Fecal hydrogen sulfide production in ulcerative colitis. Am J Gastroenterol. 1998 Jan;93(1):83-7.
  8. Sivarajah V, Abdul Q, Pardoe H, Lunniss P. Ulcerative colitis associated with the herbal weight loss supplement Hydroxycut. BMJ Case Rep. 2013 Jan 3;2013. pii: bcr2012007509. doi: 10.1136/bcr-2012-007509.
  9. Yamamoto-Furusho JK, Torijano-Carrera E. Intestinal protozoa infections among patients with ulcerative colitis: prevalence and impact on clinical disease course. Digestion. 2010;82(1):18-23. doi: 10.1159/000273871.
  10. Vukobrat-Bijedic Z, Husic-Selimovic A, Bijedic N, Bjelogrlic I, Djuran A. Intestinal amebiasis in a group of patients with ulcerative colitis: influence on clinical course of the disease. Med Arh. 2013;67(1):10-2.
  11. Lee JK, Tang DH, Mollon L, Armstrong EP. Cost-effectiveness of biological agents used in ulcerative colitis. Best Pract Res Clin Gastroenterol. 2013 Dec;27(6):949-60. doi: 10.1016/j.bpg.2013.09.007.
  12. Pezerovi D, Zulj M, Klarin I, Majnari L, Vcev I, Vcev A. Clinical expression of inflammatory bowel diseases–a retrospective population-based cohort study; Vukovarsko-Srijemska County, Croatia, 2010. Coll Antropol. 2013 Sep;37(3):919-27.
  13. Ott C, Schölmerich J. Extraintestinal manifestations and complications in IBD. Nat Rev Gastroenterol Hepatol. 2013 Oct;10(10):585-95. doi: 10.1038/nrgastro.2013.117.
  14. Patil SA, Cross RK. Update in the management of extraintestinal manifestations of inflammatory bowel disease. Curr Gastroenterol Rep. 2013 Mar;15(3):314. doi: 10.1007/s11894-013-0314-8.
  15. Jaqua NT, Stratton A, Yaccobe L, Tahir U, Kenny P, Kerns T. A review of the literature on three extraintestinal complications of ulcerative colitis: an ulcerative colitis flare complicated by Budd-Chiari syndrome, cerebral venous thrombosis and idiopathic thrombocytopenia. Acta Gastroenterol Belg. 2013 Sep;76(3):311-6.
  16. Langan RC, Gotsch PB, Krafczyk MA, Skillinge DD. Ulcerative colitis: diagnosis and treatment. Am Fam Physician. 2007 Nov 1;76(9):1323-30.
  17. Russell RK, Protheroe A, Roughton M, Croft NM, Murphy MS, Spray C, Rodrigues AF, Wilson DC, Puntis J, Cosgrove M, Tamok A, Rao P, Down C, Arnott ID, Mitton SG. Contemporary outcomes for ulcerative colitis inpatients admitted to pediatric hospitals in the United Kingdom. Inflamm Bowel Dis. 2013 Jun;19(7):1434-40. doi: 10.1097/MIB.0b013e31828133d6.
  18. Valavanis A, Tegos T. A Case of Transient Ischemic Attack in a patient with Ulcerative Colitis. Hippokratia. 2013 Jan;17(1):79-80.
  19. Rogler G. Chronic ulcerative colitis and colorectal cancer. Cancer Lett. 2013 Aug 11. pii: S0304-3835(13)00552-1. doi: 10.1016/j.canlet.2013.07.032.

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