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Ulcerative Colitis

Continuous Colonic Inflammation — Induction and Long-term Maintenance

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Ulcerative Colitis?

Ulcerative colitis is a chronic idiopathic inflammatory disease characterized by continuous mucosal inflammation limited to the colon, always involving the rectum and extending proximally.

Disease extent is classified as proctitis, left-sided colitis, or extensive colitis (pancolitis), guiding therapy choice.

Endoscopy shows continuous erythema, loss of vascular pattern, friability, and ulceration; histology reveals crypt abscesses and distortion.

Risk of colorectal cancer increases with duration, extent, primary sclerosing cholangitis, and family history.

Symptoms

Bloody diarrhea with mucus and tenesmus
Urgency, incomplete evacuation, and nocturnal bowel movements
Lower abdominal cramping relieved by defecation
Weight loss, anemia, and fatigue
Extraintestinal: arthritis, erythema nodosum, pyoderma gangrenosum, uveitis, PSC
Severe colitis: more than 6 bloody stools/day, fever, tachycardia, anemia, raised inflammatory markers

Risk Factors

Family history of IBD and genetic predisposition
Jewish Ashkenazi ancestry
NSAID use may trigger flares
Former smokers (nonsmokers at higher risk than current smokers)
Northern European or North American residence
Appendectomy at young age appears protective

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Bloody diarrhea lasting over 1 week with urgency
  • Severe symptoms: over 6 bloody stools/day, fever, tachycardia, toxic appearance
  • New bowel-related joint pain, eye redness, or skin lesions

Treatment Methods

01
Mild-moderate: oral and topical 5-ASA (mesalamine); add budesonide MMX or prednisone for flares
02
Moderate-severe: anti-TNF (infliximab, adalimumab, golimumab), vedolizumab, ustekinumab, or tofacitinib/upadacitinib
03
Acute severe UC: hospitalization, IV corticosteroids, rescue with infliximab or cyclosporine; colectomy if no response within 3–7 days
04
Maintenance with 5-ASA (mild) or immunomodulators/biologics (moderate-severe); avoid long-term steroids
05
Colonoscopy surveillance for dysplasia starting 8 years after diagnosis, sooner with PSC
06
Total colectomy with ileal pouch-anal anastomosis for refractory disease, dysplasia, or cancer

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.