Ulcerative Colitis
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that affects the large intestine (colon) and rectum.
Overview
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that affects the large intestine (colon) and rectum. Unlike Crohn’s disease, inflammation in UC is continuous and limited to the innermost lining of the bowel wall.
UC affects around 1 in 1,000 Australians, with incidence and prevalence rising globally (Ng et al., 2017). The condition often begins in young adulthood, though it can occur at any age. Left untreated, UC can cause severe bleeding, anaemia, malnutrition, and increased risk of colorectal cancer.
Common Misunderstandings
Ulcerative colitis is sometimes mistaken for food poisoning, irritable bowel syndrome, or haemorrhoids, which can delay proper diagnosis. Patients often experience years of recurring flare-ups, frequent hospital visits, or medication side effects.
The unpredictable nature of UC — alternating flares and remissions — can cause anxiety, fatigue, and difficulties with work, travel, and relationships. Many patients describe feeling dismissed or misunderstood, especially when symptoms are invisible outside of a flare.
How is Ulcerative Colitis Linked to Your Microbiome?
- Reduced microbial diversity: UC patients often show a loss of beneficial bacteria compared with healthy controls (Nishida et al., 2018).
- Loss of protective bacteria: Anti-inflammatory microbes such as Faecalibacterium prausnitzii and barrier-supporting species like Akkermansia muciniphila are decreased in UC (Sokol et al., 2008).
- Overgrowth of potentially harmful bacteria: Certain Enterobacteriaceae are more abundant and associated with active inflammation (Kostic et al., 2014).
- Gut barrier dysfunction: Dysbiosis may weaken the mucosal lining, increasing permeability and triggering immune overactivation (Ni et al., 2017).
- Therapy response: Emerging evidence suggests the microbiome may influence response to biologic therapies, though more trials are needed (Ananthakrishnan et al., 2017).
Taken together, these findings show that while UC is not caused by the microbiome alone, microbial imbalance is a key driver and perpetuator of disease activity.
Symptoms
Bloody diarrhoea
Mucus in stools
Abdominal cramping
Urgency and frequent bowel movements
Fatigue and anemia
The Microbiome Clinic™
Our treatment approach for Ulcerative Colitis includes:
Gut Microbiome Test
Profile the gut to identify dysbiosis that may be affecting symptoms or treatment using the Gut Microbiome Test.
Targeted Antimicrobial Strategies
Antibiotics and plant-based or pharmaceutical antimicrobials (where appropriate) to reduce the overgrown population of unwanted bacteria in the gut.
Probiotics and Prebiotics
Targeted probiotics and prebiotics are introduced slowly to restore balance and biodiversity of microbes in the gut without fuelling overgrowth.
Individualised Nutrition Plans
Nutrition strategies to support recovery and enhance your overall health such as a tailored low-FODMAP diet or fibre consumptions strategies.
Suspect you might have Ulcerative Colitis?
