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Ulcerative Colitis

Understanding Ulcerative Colitis 

Ulcerative colitis (UC) is a chronic inflammatory disease that affects the colon and rectum of the gastrointestinal tract. UC is associated with increased stool frequency, rectal bleeding and bowel urgency. UC-related inflammation can damage the lining of the colon and rectum, which may lead to symptoms that can get worse over time if left untreated.1

Bowel urgency (the sudden and immediate need to have a bowel movement) is one of the most challenging symptoms for many people with ulcerative colitis. In a study where people responded that their UC symptoms impact their daily life, 90% felt bowel urgency was the most disruptive symptom.2-3 Bowel urgency may lead to feelings of fear, panic, or embarrassment and can cause you to say no to plans, give up activities you love, or even avoid going out altogether.2-5

These symptoms can make it difficult for people living with UC to participate in activities such as work, school and physical exercise.6

What Causes Ulcerative Colitis?

The cause of UC is unknown but is thought to be due to a combination of factors including genetic predisposition; environmental factors, such as diet or stress; and the microbiome, a collection of microorganisms that live in association with the human body including bacteria in the intestines.7-10 These factors interact to cause an autoimmune inflammatory response resulting in the breakdown of the protective mucosal barrier of the colon and rectum.7,10


Who Gets Ulcerative Colitis? 

An estimated 1.1 million patients in the U.S. are currently living with UC.11 Although the majority of patients are initially diagnosed with mild disease and start on conventional therapy, such as aminosalicyklates and/or corticosteroids, many will progress to having moderately to severely active disease.12

Can Ulcerative Colitis Be Treated? 

UC is characterized by alternating periods of relapse (flares) and remission (symptoms have reduced or disappeared). Up to 24% of patients have continuous activity of their UC symptoms. Therapy is aimed at first inducing and then maintaining remission.13-14

 Your UC treatment could help you:  

  • Get rapid relief from blood in stools and frequent bowel movements  

  • Achieve lasting clinical remission and improved bowel urgency 

  • Reduce inflammation in your gut to heal the colon lining15

 People living with ulcerative colitis should talk to their health care practitioner openly and honestly to help ensure they fully understand the treatment options and are able to find one that works.  

1. Fiorino G, Danese S, Giacobazzi G, Spinelli A. Medical therapy versus surgery in moderate-to-severe ulcerative colitis. Dig Liver Dis. 2020;53(4):403-408. doi:10.1016/j.dld.2020.09.022 

2. Carpio D, López-Sanromán A, Calvet X, et al. Perception of disease burden and treatment satisfaction in patients with ulcerative colitis from outpatient clinics in Spain: UC-LIFE survey. Eur J Gastroenterol Hepatol. 2016;28(9):1056-1064. doi:10.1097/MEG.0000000000000658  

3. Rubin DT, Sninsky C, Siegmund B, et al. International perspectives on management of inflammatory bowel disease: opinion differences and similarities between patients and physicians from the IBD GAPPS survey. Inflamm Bowel Dis. 2021;27(12):1942-1953. doi:10.1093/ibd/izab006 

4. Devlen J, Beusterien K, Yen L, Ahmed A, Cheifetz A, Moss AC. The burden of inflammatory bowel disease: a patient-reported qualitative analysis and development of a conceptual model. Inflamm Bowel Dis. 2014;20(3):545-552. Doi:10.1097/01.MIB.0000440983.86659.81 

5. Kemp K, Griffiths J, Lovell K. Understanding the health and social care needs of people living with IBD: a meta-synthesis of the evidence. World J Gastroenterol. 2012;18(43):6240- 6249. doi:10.3748/wjg.v18.i43.6240 

6. Su S, Marrie RA, Bernstein CN. Factors Associated With Social Participation in Persons Living With Inflammatory Bowel Disease. J Can Assoc Gastroenterol. 2021 Jul 21;5(2):59-67. doi: 10.1093/jcag/gwab022. PMID: 35368323; PMCID: PMC8972209. 

7. Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel JF. Ulcerative colitis. Lancet. 2017 Apr 29;389(10080):1756-1770. doi: 10.1016/S0140-6736(16)32126-2. Epub 2016 Dec 1. PMID: 27914657; PMCID: PMC6487890. 

8. Popov J, Caputi V, Nandeesha N, Rodriguez DA, Pai N. Microbiota-Immune Interactions in Ulcerative Colitis and Colitis Associated Cancer and Emerging Microbiota-Based Therapies. Int J Mol Sci. 2021 Oct 21;22(21):11365. doi: 10.3390/ijms222111365. PMID: 34768795; PMCID: PMC8584103. 

9. Ogunrinola GA, Oyewale JO, Oshamika OO, Olasehinde GI. The Human Microbiome and Its Impacts on Health. Int J Microbiol. 2020 Jun 12;2020:8045646. doi: 10.1155/2020/8045646. PMID: 32612660; PMCID: PMC7306068. 

10. Neurath MF. Cytokines in inflammatory bowel disease. Nat Rev Immunol. 2014 May;14(5):329-42. doi: 10.1038/nri3661. Epub 2014 Apr 22. PMID: 24751956. 

11. DOF-MR-US-0020 

12. Ko CW, Singh S, Feuerstein JD, Falck-Ytter C, Falck-Ytter Y, Cross RK; American Gastroenterological Association Institute Clinical Guidelines Committee. AGA Clinical Practice Guidelines on the Management of Mild-to-Moderate Ulcerative Colitis. Gastroenterology. 2019 Feb;156(3):748-764. doi: 10.1053/j.gastro.2018.12.009. Epub 2018 Dec 18. PMID: 30576644; PMCID: PMC6858922. 

13. Cosnes J, et al. Gastroenterology. 2011;140:1785-1794.  

14. Solberg IC, et al. Scand J Gastroenterol. 2009;44:431-440 

15. Rubin DT, Ananthakrishnan AN, Siegel CA, Sauer BG, Long MD. ACG clinical guideline: ulcerative colitis in adults. Am J Gastroenterol. 2019;114:384-413. doi:10.14309/ajg.0000000000000152