Coping with ulcerative colitis (UC) can present challenges.

The National Institute of Diabetes and Digestive and Kidney Diseases reports that, according to research, this chronic disease affects close to 1 million people in the United States. It causes inflammation and sores in the lining of your colon and rectum.

As the inflammation worsens, the cells that line these areas die off, resulting in bleeding, infection, and diarrhea.

UC can cause:

  • fever
  • anemia
  • fatigue
  • joint pain
  • appetite loss
  • weight loss
  • skin lesions
  • nutritional deficiencies
  • stunted growth in children

The exact cause of ulcerative colitis is unclear. Many experts believe it results from an abnormality of the immune system and an inability to handle bacteria in the digestive tract.

Your doctor may request a blood test, stool samples, barium enema, and colonoscopy. These medical tests will allow them to determine whether ulcerative colitis is causing your symptoms or your symptoms are caused by another condition such as Crohn’s disease, diverticular disease, or cancer.

Ulcerative colitis should be confirmed by a tissue biopsy during a colonoscopy.

If you’re diagnosed with ulcerative colitis, it’s vital to work with your healthcare professional to create a treatment plan that manages and prevents attacks so that your colon can heal.

Because the symptoms and effects of the disease vary, there’s no single treatment that works for everyone. Treatments often focus on:

  • diet and nutrition
  • stress level
  • medication

It’s recommended to consume smaller amounts of food throughout the day to best help optimize the management of your condition. Avoid raw and high-fiber foods if these are problem foods for you. Examples of foods to avoid with UC include:

  • nuts
  • seeds
  • beans
  • whole grains

Fatty and greasy foods also contribute to inflammation and pain.

In general, foods that are more complementary to your digestive system when you have UC include:

  • low fiber grains
  • baked chicken, pork, and fish
  • steamed/baked or stewed fruits and vegetables

Sipping water throughout the day can aid in digestion and help reduce inflammation. Learn more about diets that may help people with UC.

Anxiety and nervousness can worsen symptoms. Exercise and relaxation techniques that help you manage and reduce your stress levels can be helpful. These include:

  • biofeedback
  • massages
  • meditation
  • therapy

Your doctor may prescribe medication to induce or maintain remission. Although several types of medications exist, each drug falls into four primary categories.


These drugs contain 5-aminosalicylic acid (5-ASA), which helps manage inflammation in the intestine.

Aminosalicylates can be administered:

  • orally
  • through an enema
  • in a suppository

They typically take 4 to 6 weeks to work. However, they may cause side effects, including:

  • nausea
  • vomiting
  • heartburn
  • diarrhea
  • headache


This group of steroid drugs — including prednisone, budesonide, methylprednisolone, and hydrocortisone — help reduce inflammation.

They’re often used if you have moderate to severe ulcerative colitis, including if you have not responded favorably to 5-ASA drugs.

Corticosteroids can be administered orally, intravenously, through an enema, or in a suppository. Side effects include:

  • acne
  • facial hair
  • hypertension
  • diabetes
  • weight gain
  • mood swings
  • bone mass loss
  • increased risk of infection

Steroids are ideally used on a short-term basis to lessen the effects of an ulcerative colitis flare-up, rather than as a daily medication to manage symptoms.

When ulcerative colitis is very severe, your doctor may prescribe a daily dose of steroids to help you maintain your typical lifestyle.


These drugs, including azathioprine and 6-mercapto-purine (6-MP), help reduce inflammation of the immune system — though they can take as long as 6 months to effectively work.

Immunomodulators are administered orally and typically used if you don’t respond favorably to the combination of 5-ASAs and corticosteroids. Potential side effects include:

  • pancreatitis
  • hepatitis
  • reduced white blood cell count
  • increased risk of infection


These medications belong to a newer class of drugs that are used as an alternative to immunomodulators to treat ulcerative colitis in people who haven’t responded well to other treatments.

Biologics are more complex and target specific proteins. They can be given through intravenous infusion or injections. Currently, there are several FDA-approved biologic medications to treat ulcerative colitis:

  • tofacitinib (Xeljanz)
  • adalimumab (Humira)
  • golimumab (Simponi)
  • infliximab (Remicade)
  • vedolizumab (Entyvio)

Find out more about using biologics to treat moderate to severe UC.

JAK inhibitors

Janus kinase (JAK) inhibitors are disease-modifying antirheumatic drugs (DMARDs). They have small molecules that are broken down by the digestive system and absorbed into the bloodstream.

JAK inhibitors work quickly, blocking pathways of inflammation in the body.

The FDA has approved the following JAK inhibitors for treatment of ulcerative colitis:

  • tofacitinib (Xeljanz)
  • upadacitinib (Rinvoq)

If other forms of treatment have not worked, you may be a candidate for surgery.

Some people with UC eventually decide to have their colons removed because of severe bleeding and illness — or an increased risk of cancer.

Four types of surgeries exist:

  • restorative proctocolectomy with ileal pouch-anal anastomosis
  • total abdominal colectomy with ileorectal anastomosis
  • total abdominal colectomy with end ileostomy
  • total proctocolectomy with end ileostomy

If you have ulcerative colitis, avoid nonsteroidal anti-inflammatory drugs (NSAIDs), which may worsen symptoms.

Work with your doctor to create a treatment strategy that best addresses your healthcare needs.

Also, because an increased risk of cancer is linked to ulcerative colitis, it’s recommended that you schedule an exam annually or every 2 years, per your doctor’s recommendation.

With the right treatment approach, it’s possible to manage your ulcerative colitis and live a typical lifestyle.

What happens if you don’t seek treatment for UC?

Ulcerative colitis can be challenging to treat. However, there are various treatment options available.

Talk with your doctor about your symptoms. Together, you can develop a treatment plan that works best for you.