If you’ve spent any time in a colitis support group, you’ve probably seen people talking about “colitis” like it’s one single condition. The truth is, colitis is a broad term that simply means inflammation of the colon. It’s not always the same as ulcerative colitis, and that’s where things get confusing.
So, let’s break it down.
What is Colitis?
Colitis is a general term for inflammation in the colon. It’s a symptom, not a diagnosis in itself. Think of it like saying “headache.” A headache can happen for all sorts of reasons, and so can colitis.
There are several types of colitis, each with different causes, treatments, and outcomes.
Ulcerative Colitis (UC): The Chronic, Autoimmune Condition
Ulcerative colitis is a form of inflammatory bowel disease (IBD) and is considered an autoimmune condition. In UC, the immune system mistakenly attacks the lining of the colon, causing persistent inflammation and ulcers.
UC is chronic, meaning it doesn’t just “clear up” with antibiotics or rest. It’s a lifelong condition that comes and goes in flares and periods of remission. UC symptoms can include bloody stools, urgency, abdominal pain, fatigue, and weight loss.
The key difference is that UC isn’t just inflammation — it’s an immune system issue that requires ongoing management.
If you're managing UC, my book Well Now: Reclaim Your Life from Ulcerative Colitis offers practical tips for calming inflammation, repairing your gut lining, and restoring microbiome balance.
Other Types of Colitis: Not All Colitis is UC
Here’s where it gets tricky. There are several other types of colitis that are completely unrelated to UC but often get confused with it.
1. Microscopic Colitis
Microscopic colitis causes chronic, watery diarrhea, but it’s different from UC because the inflammation is only visible under a microscope. There are two subtypes:
Lymphocytic colitis (where white blood cells accumulate in the colon lining)
Collagenous colitis (where the colon lining thickens with a layer of collagen)
Unlike UC, microscopic colitis doesn’t usually cause blood in the stool and is often linked to medications, infections, or autoimmune conditions.
For more information, The Crohn’s & Colitis Foundation has helpful resources on microscopic colitis.
2. Ischemic Colitis
This type happens when blood flow to the colon is reduced, often due to narrowed arteries or a sudden drop in blood pressure. It’s more common in older adults and can cause sudden abdominal pain, cramping, and bloody stools.
Ischemic colitis usually clears up once blood flow improves, but in severe cases, hospital treatment may be needed.
3. Pseudomembranous Colitis
This form of colitis is caused by an overgrowth of Clostridioides difficile (C. diff) bacteria, often after a course of antibiotics. Symptoms include severe diarrhea, fever, and abdominal pain. Unlike UC, this type is usually treated with antibiotics to clear the infection.
For further reading, Mayo Clinic provides detailed information on managing C. diff infections.
4. Infectious Colitis
This happens when a bacterial, viral, or parasitic infection causes inflammation in the colon. It’s often linked to contaminated food or water and is typically short-lived once the infection is treated.
5. Diversion Colitis
This occurs in people who’ve had certain types of bowel surgery, particularly if part of the colon is bypassed. Inflammation develops in the unused portion of the colon, and symptoms can vary.
Key Differences at a Glance
UC is autoimmune and chronic.
Microscopic colitis is linked to immune activation but isn’t the same as UC.
Ischemic colitis is related to blood flow problems.
Pseudomembranous colitis is caused by a bacterial infection, usually C. diff.
Infectious colitis is short-term and linked to food poisoning or gut infections.
Diversion colitis occurs after surgery in unused parts of the colon.
Why This Matters
It’s easy to hear the word “colitis” and assume it’s the same as UC, but the differences are important. Some types of colitis resolve quickly, while others (like UC) require long-term management. If you’re unsure what type you have, it’s always worth asking your doctor for clarity.
Understanding your diagnosis empowers you to make informed decisions about your health, and avoid confusion when scrolling through those well-meaning but sometimes misleading social media comments.
FAQs
1. Is UC the most serious form of colitis? Not necessarily. While UC is chronic and can be severe, other types of colitis (like ischemic colitis or C. diff colitis) can also be serious if left untreated. The key difference is that UC is an autoimmune condition that requires long-term management.
2. Can you have UC and another type of colitis at the same time? Yes. For example, some people with UC may develop pseudomembranous colitis after antibiotic use or experience ischemic colitis alongside UC due to reduced blood flow.
3. How can I tell if I have UC or another type of colitis? A gastroenterologist can help you get the right diagnosis. Blood tests, stool tests, colonoscopies, and biopsies are all tools doctors use to determine the type of colitis you may have.
4. Is microscopic colitis treated the same way as UC? No. While both may involve managing inflammation, microscopic colitis is often treated with diet adjustments, medications to reduce diarrhea, and sometimes eliminating certain medications that may have triggered the condition.
The Bottom (excuse the pun) Line
Not all colitis is ulcerative colitis. UC is an autoimmune condition that requires careful management, while other types of colitis may clear up with the right treatment. If you're unsure which type of colitis you have, a conversation with your doctor can make all the difference.
Got questions about UC or other forms of colitis? Drop them in the comments and I’ll do my best to help.
Thank you for being so committed to helping people gain understanding I recommend everyone to get your book very informative and life changing for those with UC.