Colitis vs. Ulcerative Colitis: What’s the Difference?

Colitis and ulcerative colitis (UC) can look very similar because they share symptoms like abdominal pain, diarrhea, and bloody stool, and they both involve inflammation of the colon (the large intestine). Despite these similarities, their root causes and treatment approaches differ. It’s important to understand the difference so you receive the right care.

“It’s important to get a proper diagnosis and start treatment right away to decrease the risk of complications like colon damage,” says Supriya Rao, MD, a gastroenterologist and the medical director of the obesity medicine program at Lowell General Hospital in Massachusetts.

Here’s everything you need to know about colitis versus UC, how they differ, and treatment options for each.

“Colitis refers to inflammation of the colon,” says Dr. Rao. “You can think of colitis as a general term, not necessarily a diagnosis on its own.” In other words, colitis is a very broad medical term used by doctors to describe any inflammation that occurs in the colon, regardless of the cause, she says.

• Abdominal pain
• Bloating
• Diarrhea
• Blood or mucus in the stool
• Lack of appetite
• Weight loss

• Infections
• Lack of blood flow
• Medications
• Autoimmune conditions like UC or Crohn’s disease
• Exposure to toxins or radiation

• Infectious colitis is caused by a virus, bacteria, or parasite.
• Ischemic colitis is caused by a lack of blood flow to the colon.
• Inflammatory bowel disease (IBD) is a group of conditions that cause long-term inflammation of the colon, like UC or Crohn’s disease.
• Radiation colitis can occur in people receiving radiation therapy for cancer.
• Diversion colitis occurs in some people who have colostomies.
• Allergic colitis occurs in breastfeeding babies who have an allergy to something that the mother eats, usually soy or dairy milk.

“UC is an autoimmune condition, meaning the immune system mistakenly attacks the cells of the colon, leading to ongoing inflammation,” says internal medicine and gastroenterology physician David D. Clarke, MD, a clinical assistant professor emeritus at Oregon Health and Science University in Portland and the president of the Association for Treatment of Neuroplastic Symptoms. “The fundamental cause is not fully understood, but genetic, immune, and environmental factors are believed to contribute.”

• Diarrhea
• Bloody stool
• Having more frequent bowel movements or the urge to pass one
• Mild abdominal pain
• Feeling like you need to poop but not being able to (tenesmus)

People with moderate to severe UC, symptoms may also experience these symptoms:

• At least four bowel movements or episodes of diarrhea per day
• Blood, mucus, or pus in stool
• Severe abdominal pain
• Fatigue or feeling extremely tired
• Weight loss
• Fever
• Nausea

• Abdominal pain
• Diarrhea
• Urgent need to poop
• Blood or mucus in the stool
• Weight loss
• Nausea
• Fever
• Fatigue

“On the surface, they’re pretty similar,” says Rao, but there are key differences:

• Colitis is a broad term used to describe any kind of inflammation of the large intestine, whereas UC is a specific type of colitis.

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• The causes of colitis and UC are different. Colitis can be caused by many different things, including infection, autoimmune issues, or lack of blood flow. UC is a specific disease caused by an overactive response by the immune system, leading the body to mistakenly attack healthy tissue.

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• How long symptoms last differs between colitis and UC. Colitis can be either acute or chronic, whereas UC is chronic.

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Dr. Clarke says that it’s important to know the differences between colitis and UC because the treatments often differ.

• Medications These may include corticosteroids that treat inflammation, immunosuppressants that treat autoimmune issues, aminosalicylates that treat IBD, or antibiotics that treat an infection, depending on the cause of your colitis.
• Surgery People with more severe types of colitis may need surgery to manage complications.
• Dietary Changes If you have acute colitis in particular, consuming foods that are low in fiber and easy to digest may help you manage symptoms. If you have chronic colitis, you may have to figure out what foods trigger flare-ups for you and limit or avoid them. Common triggers include high-fiber or dairy-containing foods.

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• Medication Aminosalicylates, corticosteroids, immunosuppressants, and biologics may help manage UC symptoms.
• Surgery If medications aren’t enough to manage your symptoms, you may need surgery. The type of surgery used to treat UC is called a proctocolectomy (removal of part or all of the colon and rectum).

• Although colitis and ulcerative colitis sound similar and share many symptoms, they’re different conditions that often have different treatments.
• There are several types of colitis with many causes, whereas ulcerative colitis is a specific type of colitis and a lifelong autoimmune disease.
• Treatments for colitis may include medication, diet changes, or surgery.
• Treatments for ulcerative colitis may include medication or surgery.