Ulcerative colitis: your treatment and follow-up
Short patient information to print or keep.
Which part of the bowel is affected?
UC usually starts in the rectum and extends continuously through different lengths of the large bowel. It mainly affects the lining. The pattern can change with treatment. Extent is not an inevitable sequence of stages.
Confirm the diagnosis
Blood and stool tests, endoscopy and biopsies are used together. Infection can resemble a flare. Calprotectin measures inflammation, while FIT measures blood. Neither establishes UC alone or replaces an indicated bowel examination.
Use treatment as prescribed
Mesalazine may be given by mouth, rectally or both. Steroids can settle a flare but are not maintenance treatment. Follow the prescribed course and any reduction plan. Do not stop suddenly without advice. Other medicines may provide longer control.
Keep monitoring
Feeling well does not always prove inflammation has settled. Blood tests, calprotectin and selected endoscopy assess control and safety. Recommended surveillance is separate from population screening and is not replaced by a negative FIT. Relevant follow-up will be documented in your endoscopy and/or histology report once tissue results are available.
Medicines, food and pregnancy plans
Keep prescribed maintenance treatment. Discuss nutrition, pregnancy plans, side effects or practical difficulties before changing medicines. Surgery can remove colonic disease, but pouch problems or symptoms outside the bowel may still need care.
Get help early
Worsening blood or urgency needs advice. Frequent bloody diarrhoea with fever, weakness or dehydration, severe pain, swelling or heavy bleeding needs urgent assessment. A painful red eye or changed vision also needs urgent assessment. Do not self-treat a severe flare with loperamide. Call 111 for collapse or unsafe travel.
Do not wait with a severe flare
Frequent bloody diarrhoea with fever, a fast heartbeat, marked weakness or difficulty keeping fluids down needs urgent same-day assessment. Severe or worsening pain, a swollen abdomen, heavy bleeding or feeling faint also need urgent help. Do not wait for a routine stool result or an email reply.
Do not take loperamide or similar medicines for a severe flare without clinical advice. Seek urgent assessment for a painful red eye or a change in vision.
Call 111 if you collapse, have heavy bleeding with faintness, or are too unwell to travel safely.
General information. Follow your own care instructions.