Ulcerative Colitis — Patient Information
A clear guide for Valley Gastroenterology patients.
What is ulcerative colitis?
Ulcerative colitis (UC) is a chronic inflammatory disease that affects the lining of the colon and rectum. Inflammation starts in the rectum and extends continuously to a variable distance. UC causes flares with symptoms and periods of remission.
Extent
  • Proctitis: rectum only
  • Left‑sided colitis: up to the splenic flexure
  • Extensive colitis/pancolitis: beyond the splenic flexure
Common symptoms
  • Bloody diarrhea, urgency, mucus
  • Abdominal cramping, tenesmus (feeling you need to go even when empty)
  • Fatigue, low appetite, weight loss (with moderate–severe disease)
Red‑flags — call us promptly
  • Frequent bloody stools, severe abdominal pain, fever
  • Dehydration, dizziness, or fast heart rate
  • Severe flare not improving in 24–48 hours
If severe pain, fainting, or signs of shock occur, call 911 or go to the nearest ER.
How UC is diagnosed
  • History/exam and labs (CBC, CRP/ESR, electrolytes, iron studies)
  • Stool tests to rule out infection; fecal calprotectin to measure inflammation
  • Colonoscopy with biopsies to confirm UC, define extent, and assess severity
Treatment goals
  • Induce remission (stop bleeding, normalize bowel habits)
  • Maintain remission (prevent flares)
  • Promote mucosal healing, normal nutrition, and quality of life
Treatment options (personalized)
Mild proctitis/left‑sided disease
  • Mesalamine (5‑ASA) rectal therapy (suppository/enema) ± oral 5‑ASA
  • Short steroid enemas/foams during flares if needed
Moderate–severe disease or refractory to 5‑ASA
  • Corticosteroids (short term) to induce remission
  • Advanced therapies for maintenance/long‑term control:
  • Biologics: anti‑TNF (e.g., infliximab, adalimumab), vedolizumab, ustekinumab
  • Small‑molecule agents: JAK inhibitors (e.g., upadacitinib; tofacitinib in select cases), S1P modulators (e.g., ozanimod)
  • Medication choice depends on severity, comorbidities, prior response, and preferences
Supportive care
  • Replete iron, B12, vitamin D if low
  • Nutrition: balanced diet; consider low‑residue during flares; dietitian support as needed
Surgery
  • Considered for severe, steroid‑dependent, medically refractory disease, dysplasia/cancer, or fulminant colitis/megacolon. Curative option is colectomy with creation of an ileal pouch (J‑pouch) in selected patients.
Monitoring & preventive care
  • Regular follow‑ups with symptom scores and labs; track fecal calprotectin as needed
  • Drug safety labs; TB/hepatitis screening before biologics/JAKs
  • Vaccinations: keep up‑to‑date (influenza, COVID‑19, pneumococcal, hepatitis A/B, HPV, shingles as appropriate). Avoid live vaccines on immunosuppression—ask us.
  • Colon cancer surveillance: if UC involves much of the colon for >8 years, colonoscopy at recommended intervals with targeted biopsies/chromoendoscopy
Pregnancy & family planning
Most patients can have healthy pregnancies. Aim for disease remission before conception. Many UC medications are compatible; discuss plans with GI and OB/GYN.
Flare plan (call us to personalize)
  • Confirm no infection (stool tests if needed)
  • Optimize rectal therapy for distal disease
  • Short steroid course if appropriate; escalate maintenance therapy if flares recur
  • Hydrate, rest, and track symptoms; seek urgent care for red‑flags above
Alaska‑specific note
We offer telehealth for routine visits and coordinate local labs. Weather or road issues? We’ll reschedule without penalty and help minimize travel.
Next steps
If you have ongoing rectal bleeding, urgency, or abdominal pain, schedule a visit for evaluation. We’ll confirm the diagnosis, define extent, and build a stepwise treatment plan.
Valley Gastroenterology
3190 E Meridian Park Loop, Suite 206
Wasilla, Alaska 99654
Phone: (907) 373-2544
Fax: (844) 689-4240
Web: ValleyGastroAK.com