Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory bowel disease (IBD) in which the immune system contributes to ongoing inflammation in the lining of the large intestine. This ongoing inflammation can lead to irritation, ulcers, bleeding, and changes in bowel function such as diarrhea. The condition typically develops gradually and may alternate between periods of remission and active flare-ups.

Unlike Crohn’s disease, which can affect any part of the digestive tract, ulcerative colitis is limited to the colon and rectum.

Symptoms vary depending on the severity and extent of inflammation. Common symptoms include:

• Diarrhea
• Abdominal pain
• Rectal bleeding
• Urgency to have bowel movements
• Fatigue

Some patients also experience weight loss, anemia, fever, or loss of appetite during flare-ups. Because symptoms can worsen over time without treatment, early evaluation is important.

What causes Ulcerative Colitis?

The exact cause of ulcerative colitis is not fully understood. Researchers believe it results from a combination of immune system dysfunction, genetics, and environmental factors. In people with ulcerative colitis, the immune system triggers inflammation in the colon even when no infection is present.

Who is most at risk? 

Ulcerative colitis can affect people of all ages, but it is often diagnosed between the ages of 15 and 35. Individuals with a family history of inflammatory bowel disease (IBD) may have a higher risk. Environmental factors, diet, and certain infections may also play a role in triggering symptoms.

Ulcerative colitis is classified based on which part of the colon is affected: 

• Ulcerative proctitis affects only the rectum
• Left-sided colitis extends through the left side of the colon
• Pancolitis involves the entire colon

The extent of inflammation often influences symptom severity and treatment recommendations.

Diagnosing ulcerative colitis involves a combination of symptom evaluation, laboratory testing, imaging, and endoscopic procedures.

When to see a physician

You should seek medical evaluation if you experience persistent diarrhea, rectal bleeding, abdominal pain, unexplained weight loss, or ongoing urgency with bowel movements. These symptoms should not be ignored, especially if they interfere with daily life.

What to expect at your appointment

Your gastroenterologist will review your symptoms, medical history, and family history in detail. A physical exam and discussion about bowel habits, diet, and symptom patterns help guide the diagnostic process.

Tests and procedures

Testing may include blood work, stool studies, colonoscopy, and imaging such as intestinal ultrasound or CT scan or MRI. Colonoscopy is one of the most important tools for diagnosing ulcerative colitis because it allows direct visualization of inflammation and enables biopsies to confirm the diagnosis. 

NYGA offers advanced diagnostic tools, including intestinal ultrasound, to help monitor inflammation and treatment response in patients with IBD.

Medications

Depending on disease severity, treatment may include anti-inflammatory medications, immunosuppressants, biologic therapies, or advanced infusion therapies. The goal is to mangage symptoms and get patients into remission in order to reduce flare-ups, prevent complications, and improve quality of life.

Our team at NYGA also offers cutting edge drug trials for inflammatory bowel disease when conventional therapies have been exhausted or fail.

When surgery is considered

Surgery may be recommended for severe cases that do not respond to medication or when complications develop. Surgical treatment may involve removing part or all the colon, depending on the condition and the patient's overall health.

Diet and nutrition

Dietary changes can help reduce irritation and support digestive health. Certain foods may worsen symptoms during flare-ups, so individualized nutrition guidance is often an important part of treatment. NYGA also offers nutrition counseling and telehealth nutrition services to support patients with IBD.

Managing flare-ups

Managing stress, staying hydrated, taking medications consistently, and attending regular follow-up visits can help reduce the frequency and severity of flares. Monitoring symptoms early may help prevent complications and improve long-term disease control.

At NYGA, our gastroenterologists provide comprehensive care for ulcerative colitis using advanced diagnostics, infusion therapy, nutrition support, and personalized treatment strategies.

If you are experiencing symptoms of ulcerative colitis or need ongoing IBD care, schedule an appointment with NYGA today to receive expert evaluation and long-term support from one of NYC’s leading gastroenterology practices.