Ulcerative Colitis
Ulcerative colitis is a chronic condition in which the inner lining of the large intestine becomes inflamed and develops shallow ulcers. Unlike Crohn’s disease, it stays confined to the colon, typically starting at the rectum and extending upward. Flares can be disruptive, but most people manage the condition well with appropriate treatment.
Azulfidine
500mg
Sulfasalazine 500mg tablets, used in the management of rheumatoid arthritis, ulcerative colitis and Crohn's disease. A sulfonamide DMARD.
Key points
- The immune system drives inflammation and shallow ulceration limited to the colon’s lining, unlike the deeper, patchy damage seen in Crohn’s disease.
- Bloody, mucus-streaked diarrhoea alongside cramping and fatigue signals a flare, with severity ranging widely between people.
- Mesalazine is typically the first medicine tried for milder disease, while sulfasalazine remains a common older alternative.
- Giving up smoking is one of the few habits reliably tied to a better long-term course of the disease.
Recognising a flare
The hallmark symptom is bloody diarrhoea, often with mucus. Other common signs include an urgent need to empty the bowels, cramping low in the abdomen, and general fatigue. Flares vary from mild (a few loose stools a day) to severe (six or more a day with significant bleeding). Symptoms that persist beyond a few days, or any episode with high fever or signs of dehydration, warrant prompt medical assessment.
How inflammation is controlled
The main treatment goal is reducing and maintaining remission. Mesalazine is the standard first-line choice for mild to moderate disease; it works directly on the colon lining with minimal systemic effect. Sulfasalazine is an older aminosalicylate that remains widely used, particularly where cost is a factor, and carries a modest benefit for joint symptoms that sometimes accompany the disease. Both belong to the broader digestive health category. For more severe or steroid-dependent disease, immunosuppressants or biologics are added under specialist care.
Day-to-day management
Keeping a food and symptom diary helps identify personal triggers, though ulcerative colitis is not caused by diet. Stress amplifies flares in many patients, common in high-pressure urban settings, so practical stress management supports medical treatment. Stopping smoking, if applicable, is one of the few lifestyle factors consistently linked to worsening the condition. Regular follow-up and colonoscopy at the intervals your doctor recommends are important for long-term monitoring.