What Is Ulcerative Colitis – Symptoms & Difference from Crohn’s Disease


What is ulcerative colitis?

So, let’s take a look at what is ulcerative colitis and its symptoms and complaints. Literally translated, ulcerative colitis means “colon inflammation with ulceration”. It is an autoimmune disease of the intestine and is localized only in the large intestine.

Along with Crohn’s disease, colitis is the most common chronic inflammatory bowel disease (IBD). Autoimmune diseases lead to misdirection of the immune system.

As a result, the body recognizes its own cells as enemies and fights them massively.

In ulcerative colitis, an autoimmune reaction occurs both against the upper intestinal mucosa and against the intestinal bacteria that have implanted therein.

In the past, scientists assumed that it was a chronic inflammation in which bacteria infected the upper intestinal mucosa and against which the immune cells act.

It is an autoimmune disease

However, it is now known that it is an autoimmune disease. The appearance of autoantibodies against the upper intestinal mucosa, the chronic and relapsing course of the disease and the general symptoms such as fever and joint pain support this statement.

Ulcerative colitis begins in the rectum, spreads from there to the entire colon, and comes to a stop at the transition to the small intestine.

In 10% of cases, the autoimmune disease Crohn’s disease develops, which affects the entire gastrointestinal tract.

In the USA, about 1.6 million people are affected by ulcerative colitis, as many as by Crohn’s disease. Every year, 70,000 new cases get reported. There are as many male as female victims.

The chronic inflammation of the colon and the immune reaction, ulcers (ulcerations) form can be found in the entire colon. Ulcerative colitis occurs, therefore, in different forms depending on the spread and locus.

Ulcerative colitis forms


This form only infects the rectum.


This type occurs in 20% of those affected, and it affects the entire colon.

Proctosigmoid ulcerosa

Here, the disease extends into the sigma loop.

Left Colitis

The inflammation extends to the last curve (left flexure), this form occurs in 30 – 40% of all sufferers.

Fulminant ulcerative colitis

Toxic megacolon, intestinal rupture and heavy intestinal bleeding occur. With this form, the patient must visit a hospital immediately.

Ulcerative colitis forms

In every second affected person, the disease is mild to moderately severe. Only individual parts of the colon are then affected.

But how do ulcerative colitis and Crohn’s disease differ?

Differentiation between ulcerative colitis and Crohn’s disease – an overview

Both autoimmune diseases are the main inflammatory bowel diseases (IBD). Both affect around 1.6 million people in America who suffer from IBD, with 70,000 new cases every year. However, the diseases differ significantly, as the table shows:

Crohn’s disease

No central inflammatory focus, the entire gastrointestinal tract is affected.

Spread occurs throughout the gastrointestinal tract.

All layers of the intestinal wall are affected.

Little blood and mucus in the stool.

Fistula formation.

Lower risk of colorectal cancer than ulcerative colitis.

Ulcerative colitis

Few, intense foci of inflammation.

Spread occurs only in the large intestine.

Only the upper layer of the intestinal mucosa is affected.

Bleeding and slimy diarrhea.

No fistula formation, but ulcers (see picture below) and pseudopolyps.

Significantly increased risk of colon cancer compared to the unaffected population.

Ulcerative colitis – symptoms and complaints

How does ulcerative colitis manifest itself?

The symptoms of chronic inflammatory bowel disease are:

1- Bloody diarrhea with mucus and pus (key symptom for diagnosis).
2- Chronic fatigue, especially during a push.
3- Inexplicable weight loss.
4- Symptoms appear in episodes.
5- Abdominal pain, mostly after meals.
6- Abdominal cramps on the left lower abdomen.
7- Frequent bowel movements (up to 20 times a day during an acute episode).
8- The feeling of having to go to the toilet all the time.
9- The feeling of never being empty.
10- The symptoms mentioned are particularly noticeable in the abdominal region, more precisely in the large intestine. Symptoms also appear outside the gastrointestinal tract.

Extra-mental manifestations:

1- Joint pain.
2- Inflammation of the eye (uveitis).
3- Skin lesion and skin inflammation.
4- Growth disorders in children.
5- During an acute episode, such as fever, rapid heartbeat, weakness, anemia.
6- Important comorbidities in ulcerative colitis
7- PSC (primary sclerosing cholangitis): small bile ducts in the liver become inflamed, narrow and scarred. This can result in hepatitis (inflammation of the liver). Those affected have a 500% increased risk of colon cancer.
8- Multiple sclerosis.
9- Ankylosing spondylitis.
10- Inflammation of the eye.
11- Osteoporosis.
12- Crohn’s disease.

The symptoms mentioned in the colon and outside the intestine speak for ulcerative colitis. The complaints do not have to occur together and can have different degrees of severity.

Frequent bowel movements and bloody and slimy diarrhea as the main symptom are corresponding symptoms.

If these occur in batches and in the long term, I highly recommend a visit to the doctor to make a possible ulcerative colitis diagnosis.

Who diagnoses ulcerative colitis?

The first point of contact is your family doctor, alternative practitioner or functional doctor. If the suspicions of ulcerative colitis accumulate, they will refer you to a gastroenterologist.

Gastroenterologists (in addition to functional medical professionals) have the necessary knowledge and methodology to diagnose ulcerative colitis. They carry out the diagnoses according to the criteria and guidelines of the FDA.

Dear co-creators

Be so kind and let us know in a comment below how you are personally handling your ulcerative colitis or any other stomach inflammation you may suffer from.

Do you have a specific home remedy, keep a special diet and lifestyle?

Whatever it may be, please, share your tips with us, so others can improve their health, as well.

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I want to thank you for your courage, loyalty and existence. You are cherished, appreciated and immensely loved. ~Namaste~


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