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Ulcerative colitis is an inflammatory bowel disease that occurs primarily in the colon, or large intestine. It’s characterized by the inflammation and ulceration (erosions) of the innermost lining of the colon, most commonly affecting the left side of the colon and the rectum.

WakeMed’s gastroenterologists and colorectal surgeons understand the intricacies of this complex and chronic condition, and we have access to the latest therapies to provide customized treatment for each patient.

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What Are the Symptoms of Ulcerative Colitis?

Symptoms of ulcerative colitis can vary, depending on whether it’s affecting the entire colon or if it’s limited to the rectum. Symptoms can include:

  • Cramps or abdominal pain
  • Diarrhea or rectal urgency
  • Rectal bleeding
  • Fever
  • Loss of appetite
  • Weight loss
  • Anemia
  • Constipation
  • Poor growth

Because ulcerative colitis is a chronic condition, symptoms can come and go over the course of a patient’s life. Some patients experience months or years of remission in between flare ups.

How Is Ulcerative Colitis Diagnosed?

Our experts are experienced in accurately diagnosing ulcerative colitis, which can also present itself like other inflammatory bowel diseases (IBD) including Crohn’s disease. We first take a full medical history and perform a physical examination. Diagnostic tests to confirm ulcerative colitis may include:

  • Blood tests
  • Stool studies
  • Computed tomography (CT) and magnetic resonance imaging (MRI) scans
  • Colonoscopy, in which a lighted, flexible tube looks at the inner lining of the colon to check for inflammation

How Is Ulcerative Colitis Treated?

The goal of treatment is to control inflammation and relieve symptoms of pain, diarrhea and rectal bleeding.

Medications can not only relieve symptoms, but can also promote the healing of damaged tissue, postpone surgery, keep the disease from flaring up and even put it in remission.

Medications used to treat ulcerative colitis include:

  • Anti-inflammatories: Including mesalamine, sulfasalazine and asacol, these can help decrease inflammation and help in maintaining disease remission.
  • Steroids: Including prednisone and budesonide, steroids are most commonly used for patients with moderate to severe symptoms. Steroids can be taken both orally or rectally.
  • Immunomodulators: Including Imuran, these are given to patients who do not respond to or are unable to take anti-inflammatories or steroids. 
  • Biologic medications: Including Remicade and Humira, biologic medications are given as IV infusions or injections, these medications reduce inflammation.
  • Newer agents: Our physicians are experts in providing the newest medication treatments for ulcerative colitis, including Entyvio and Xeljanz.

When Is Surgery Needed for Ulcerative Colitis?

In severe cases, or when a patient doesn’t respond to medication, surgery may be necessary to remove part or all of the colon.

At WakeMed, ulcerative colitis patients can have minimally invasive, laparoscopic-assisted surgeries. This allows a patient to have less pain and discomfort, smaller incision, quicker recovery and fewer complications. 

Learn more about what to expect from colorectal surgery.

Is Nutritional Counseling for Ulcerative Colitis Helpful?

Since ulcerative colitis can reduce the body's ability to absorb necessary nutrients, talking to a nutritionist can also be helpful. We offer our patients nutrition counseling to help them manage their conditions and make smart nutritional choices.