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Ulcerative Colitis

The below information is purely for educational purposes and does not constitute medical advice. This content should not be used as a substitute for professional medical advice.

What is Ulcerative Colitis?

Ulcerative colitis is an autoimmune condition caused by the body’s immune system attacking itself. This causes inflammation in the gut wall. The inflammation may be limited to just the rectum or may extend in a continuous manner to affect part or the whole colon. Between 1 to 2 in 1,000 adults in the UK are affected by ulcerative colitis.

What Causes Ulcerative Colitis?

The causes of ulcerative colitis are not entirely known but it is thought to be a result of complex interactions between a person’s genes and their environment. Having a family member with ulcerative colitis or another autoimmune condition is associated with an increased likelihood of developing ulcerative colitis. Between 10-20% of patients with ulcerative colitis will have a family history of inflammatory bowel disease.

Symptoms of Ulcerative Colitis

Symptoms can vary depending on the amount of the gut affected and severity. The most common symptoms include:

  • Diarrhoea
  • Blood mixed in with bowel motions
  • Tummy pain
  • Pain on passing a bowel motion
  • Periods of constipation
  • Loss of weight
  • Fatigue
  • Pale skin

Some patients may develop symptoms due to complications of their ulcerative colitis including bowel dilation, bowel obstruction, bowel leak, or severe bleeding. Some patients may also develop symptoms in other parts of the body including skin rashes (erythema nodosum or pyoderma gangrenosum), joint pain, back pain, eye inflammation, fragile bones and bile duct problems (primary sclerosing cholangitis).

Patients with ulcerative colitis are also at a higher risk of developing bowel cancer. As such patients should undergo regular colonoscopy according to their particular risk of developing cancer.

How is Ulcerative Colitis Diagnosed

Ulcerative colitis is most commonly diagnosed via blood tests, stool samples and scans which can all help towards making a diagnosis.

The gold standard for diagnosis is to insert a flexible telescope into the anus and around the colon (colonoscopy) or into the final section of the large bowel (flexible sigmoidoscopy) to collect a sample of tissue (biopsy) to be examined under a microscope.

Ulcerative Colitis Treatment

Treatment for ulcerative colitis is separated into two components:

  • To treat active symptoms (flare-up) and then once a flare-up is settled to maintain remission. Treatment for ulcerative colitis is managed in specialist settings. Flare-ups are treated with a short course of immunosuppressant with an aminosalicylate (e.g. mesalazine, sulfasalazine) and/or corticosteroids.
  • Remission is maintained using a stepwise approach starting with an aminosalicylate and adding in second-line therapies (e.g. azathioprine, 6-mercaptopurine) as required. Some patients may require treatment with special medications made from antibodies or surgery.
  • Many patients with moderate-to-severe disease may also require newer medications that affect the immune system called biological agents or biologics.

Medicinal cannabis can be considered for associated symptoms of ulcerative colitis when first and second-line therapies have not achieved adequate benefit.

Ulcerative Colitis and Medicinal Cannabis

Research into the effect of medicinal cannabis on ulcerative colitis is limited. However, following the legalisation of cannabis for medical purposes in 2018, there has been a rise in people looking towards medical cannabis. When first-line therapies have not proved effective at reducing symptoms, medical cannabis may be considered an option for ulcerative colitis.

For further information and to find out more about medical cannabis, click here to discover more about our award-winning Curaleaf Access Scheme. Alternatively, complete an eligibility assessment now. Once complete, one of our clinicians will review your application and advise whether you are eligible for progression to an appointment.


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Frequently Asked Questions about Ulcerative Colitis

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The bleeding in acute ulcerative colitis is due to inflammation. Bleeding due to acute ulcerative colitis requires specialist management and depending on the severity will likely require treatment within an emergency department or as a hospital inpatient. The type of treatment will depend on the severity of the condition at that time.

It is possible to also experience rectal bleeding when ulcerative colitis is in remission. It is still important to seek appropriate healthcare to make sure it is adequately investigated to ensure the right treatment is administered.

Accordion Content

Colitis refers to inflammation of the colon. There can be many conditions that cause this, such as infections or lack of blood flow to the bowel. Ulcerative colitis is a specific cause of colitis. The gold-standard method to distinguish ulcerative colitis from other types of colitis is by using an endoscope to take biopsies from the large bowel.

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There is little evidence to suggest any specific foods cause ulcerative colitis. However, the diet of an individual with ulcerative colitis may need to be modified as they are at increased risk of malnutrition. In addition, additional advice may be required when planning pregnancy or if they are affected by a complication, such as a colonic stricture. It is important that any changes are made with the oversight of a trained professional to ensure they are receiving adequate nutrition from their diet.