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Ulcerative Colitis


Ulcerative Colitis

Ulcerative colitis (UC) is one of the two main forms of Inflammatory Bowel Disease (IBD). There are many features it shares with Crohn's Disease (the other main form of IBD). However, there are some key differences.

The first key difference is in the location. Crohn’s disease can affect any part of the digestive tract from Mouth to Anus, but Ulcerative Colitis only affects the colon. However, to complicate matters, Crohn’s disease may be restricted to the colon (Crohns colitis). In which case, it may be difficult to distinguish between Crohn’s and UC.

The second key difference is in the type of Inflammation. UC affects a continuous patch of intestine, whereas Crohn’s disease can ‘skip’ areas, leaving patches of healthy tissue in between. The ulcers in UC are also restricted to the upper layer of tissue, whereas the inflammation of Crohn’s disease can spread deeper.

In some cases, it is impossible to distinguish between the forms of IBD, and a diagnosis of Indeterminate IBD may be given.

In Ulcerative Colitis patients, the mucus layer which helps protect the intestinal epithelium from digestive tract microbes, is much thinner than in persons that do not have Ulcerative Colitis.[1]

The thinner mucus layer seen in Ulcerative Colitis patients, allows microbes access to intestinal Mucosa, triggering inflammation.[1]

Fewer mature Goblet Cells, which secrete digestive tract mucus, are found in Ulcerative Colitis patients.[1]


  • Abdominal pain
  • Diarrhoea
  • Bleeding from the anus

Since the primary function of the colon is to remove water from the stool, diarrhoea is extremely common in patients with UC. As with other IBDs, not all patients will experience all the symptoms.


Diagnosis between Crohn's Disease and Ulcerative Colitis is a multifaceted approach. One major diagnostic tool is a blood test looking at multiple disease-specific markers, called the Prometheus IBD sgi Diagnostic.

If you think you may be suffering from an IBD, it may be helpful to keep a diary (see diary inclusions) as this will help your doctor build up a picture of your symptoms, and ensure they take your concerns seriously. It can also help the doctor to decide whether to order diagnostic tests to try to confirm or rule out an IBD diagnosis.

Here are some Questions you might like to ask your doctor.


The treatment options are similar to those for Crohn’s disease. However, the biologic drugs are less likely to be used, as a total colectomy (removal of the entire colon) is considered a ‘cure’ for UC.

Risk Factors Affecting Ulcerative Colitis

Hormone Replacement Therapy (HRT) taken by Women as a treatment for Menopause has recently been reported to be a Risk Factor for Ulcerative Colitis [2]


1. Gersemann M, Stange EF and Wehkamp J. From intestinal stem cells to inflammatory bowel diseases. World J Gastroenterol. 2011;17(27): 3198–3203.

2. Oswald K. HRT linked to ulcerative colitis in postmenopausal women. Gastroenterology. 2012. MedWire News. Updated August 2012. Accessed August 2012. Hormone Replacement Therapy Linked to Ulcerative Colitis

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