Ulcerative Colitis

Ulcerative colitis, also known as ulcerative proctocolitis, is a chronic inflammatory disease of the large intestine, characterised by continuous inflammation of the mucosa of the colon and rectum, which may lead to ulcer formation. It mainly presents with gastrointestinal symptoms such as diarrhoea, rectal bleeding and abdominal pain, and belongs to the group of inflammatory bowel diseases, alongside Crohn’s disease.

Inflammation typically affects the rectum (ulcerative proctitis) and may progressively extend to the colon. In more extensive forms, the entire large intestine may be involved (pancolitis).

The exact cause of ulcerative colitis remains unknown. Scientific evidence suggests a combination of genetic factors and immune system dysfunction, with certain environmental factors potentially acting as triggers.

Symptoms may vary in severity over time. The most common include:

• Persistent diarrhoea;
• Presence of blood or mucus in the stools;
• Abdominal pain;
• Anaemia and weight loss;
• Infertility;
• Episodes of constipation.

Extra-intestinal manifestations may also occur, such as joint pain and skin or eye changes, usually associated with active phases of the disease.

Diagnosis is based on clinical evaluation, with colonoscopy or rectosigmoidoscopy and biopsy sampling being essential. These examinations confirm the diagnosis, assess disease extent and exclude other conditions with similar symptoms.

Treatment is individualised and guided by a gastroenterologist, with the aims of inducing remission and preventing relapses. It may include:

• Intestinal anti-inflammatory medications;
• Immunomodulators (drugs that regulate the immune system);
• Biological therapies (antibodies targeting specific proteins to block inflammation).

In the vast majority of patients, a normal quality of life is achievable with appropriate follow-up.

Surgery may be required in specific situations, such as severe pancolitis.

Diet and lifestyle

• Maintain a balanced diet tailored to individual needs;
• Avoid foods that worsen symptoms;
• Assess lactose intolerance and adopt lactose-free alternatives if necessary;
• Avoid certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), for example ibuprofen;
• Nutritional supplementation may be recommended in cases of significant dietary restrictions.