What is Ulcerative Colitis? A Functional Medicine Guide To UC Symptoms + Causes

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As a functional medicine practitioner, I am all too familiar with chronic gut problems. Ulcerative colitis is one of the more common autoimmune conditions that I see in my telehealth clinic, as many people come to me after years spent on medications with little to no relief. By identifying the underlying cause of ulcerative colitis, I am able to help people reclaim their health and get their life back from the debilitating and painful symptoms of this condition. So what exactly is the driving force behind UC? Let’s find out.


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What is ulcerative colitis?

Ulcerative colitis is a chronic inflammatory bowel disease characterized by inflammation and ulcers in the lining of your colon and rectum. This autoimmune disorder occurs when your body's immune system mistakenly attacks your digestive tract. The severity of symptoms and the frequency of flare-ups can vary dramatically between people and can range from mild to severe. Since there is no single ulcerative colitis cause, managing this condition in functional medicine can take a multifaceted approach and include lifestyle changes, dietary changes, and natural supplements.

The many sides of ulcerative colitis

There are actually many different forms of ulcerative colitis based on the location and severity of the inflammation inside your colon and rectum. 

  • Ulcerative Proctitis: This type affects your rectum, causing inflammation in this area. Symptoms can include rectal bleeding, a consistent urge to pass stools, and mild discomfort.
  • Proctosigmoiditis: In this type, inflammation extends beyond your rectum, into the sigmoid colon - the lower part of your colon. Symptoms include bloody diarrhea, abdominal cramps, and a frequent urge to empty the bowels.
  • Left-sided Colitis: Inflammation extends from the rectum up to the splenic flexure, affecting the left side of the colon. Symptoms include bloody diarrhea, abdominal pain on the left side, weight loss, and fatigue.
  • Pancolitis (Universal Colitis): This type of ulcerative colitis affects your entire colon, from your rectum to your cecum (the beginning of the colon). Symptoms can be more severe and encompass everything from severe diarrhea, abdominal pain, fatigue, weight loss, and significant complications if left unchecked.

Depending on your case, the extent of your ulcerative colitis can change over time and you may even experience different types of ulcerative colitis throughout your life.

What is the main cause of ulcerative colitis?

Again, there is no single ulcerative colitis cause. As with any other autoimmune disease, researchers and functional medicine practitioners alike understand that this condition is likely a result of multiple different factors including genetic predisposition, environmental toxins, stress, and underlying gut problems. In fact, recent studies (1) have linked the development of ulcerative colitis to be partly caused by bacterial dysbiosis (an imbalance of bacteria in your microbiome, specifically reduced levels of the bacteria Firmicutes and increased levels of Bacteroidetes bacteria) that ends up influencing your immune response and intestinal barrier function leading to chronic inflammation.

Ulcerative Colitis symptoms

Symptoms of ulcerative colitis aren’t always the same from person-to-person however, these are the most common symptoms I see that people with ulcerative colitis face.

  • Abdominal pain or cramping
  • Blood or pus in your stool
  • Diarrhea (also with the occasional pus or blood)
  • Fatigue
  • Fever
  • Weight loss
  • Frequent urge to pass a bowel movement (even when there is nothing there)

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Possible complications or risks

Although ulcerative colitis is a chronic condition that never goes away, if left unaddressed without any proper management, ulcerative colitis can lead to more severe symptoms such as:

    • Anemia: Due to blood loss, some people may develop anemia, resulting in fatigue and weakness.
    • Joint pain: Inflammation associated with ulcerative colitis can affect joints, leading to pain and swelling.
    • Skin and eye problems: In some cases, ulcerative colitis may cause skin rashes, sores, or inflammation in the eyes.
    • Delayed growth: In children with this condition, a lack of proper care can result in delayed growth and development.
    • Toxic megacolon: This life-threatening condition happens when your colon becomes extremely enlarged due to high inflammation levels and can increase your risk for infection, dehydration, and shock.
  • Increased risk of colon cancer: On average, you have a 3.7% greater risk (2) of developing colon cancer if you have ulcerative colitis.

According to the Chron’s and Colitis Foundation, (3) your risk of developing ulcerative colitis is anywhere between 1.6 percent and 30 percent if a first-degree relative also has this condition. But in general, ulcerative colitis doesn’t discriminate when it comes to gender, age, or race, with the average age of first diagnoses being 30.

Treating ulcerative colitis

While you can’t cure ulcerative colitis, there is a lot that you can do to treat it and mitigate its symptoms - even to the point of remission. In conventional medicine the standard treatment usually involves medications aimed at lowering inflammation levels and surgery in some cases if medication isn’t successful. 

Functional medicine on the other hand focuses on identifying and treating the root cause of the inflammation that is contributing to your ulcerative colitis symptoms. Since everyone’s biochemistry is unique, there is not a “one-size-fits-all” treatment plan but it can include things like:

  • Stress management
  • Probiotic supplements
  • Omega-3 fatty acids
  • Curcumin supplements
  • Dietary changes
  • Exercise

When to seek professional medical help

If you identify with any of the following points, it is time to seek professional medical help. Catching ulcerative colitis early provides the best chance at putting symptoms in remission.

  • Ongoing abdominal pain
  • Persistent fever
  • A sudden worsening of symptoms
  • New symptom development
  • Sudden blood in stool
  • Persistent diarrhea

How a functional medicine approach can make a difference

Because ulcerative colitis is an inflammatory autoimmune condition, functional medicine is able to address the root cause more effectively than most other conventional medicine doctors. By delving into the unique genetic, environmental, and lifestyle influences of each person, through comprehensive evaluations and testing, functional medicine is able to create personalized treatment plans that are designed to address the root causes of this disease for each individual. Plus, unlike surgery and medications, functional medicine provides natural solutions that result in long-term, sustainable healing without the side effects.

If you are diagnosed with ulcerative colitis or think your symptoms might be connected to this condition, schedule a telehealth consultation today to learn more about how we can help you with functional medicine.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe. 

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  1. Shen, Zhao-Hua et al. “Relationship between intestinal microbiota and ulcerative colitis: Mechanisms and clinical application of probiotics and fecal microbiota transplantation.” World journal of gastroenterology vol. 24,1 (2018): 5-14. doi:10.3748/wjg.v24.i1.5
  2. Eaden JA, Abrams KR, Mayberry JFThe risk of colorectal cancer in ulcerative colitis: a meta-analysisGut 2001;48:526-535.
  3. Crohn’s and Colitis Foundation “Overview of Ulcerative Colitis” Accessed November 2023. https://www.crohnscolitisfoundation.org/what-is-ulcerative-colitis/overview

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Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is the host of the popular The Art Of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, The Inflammation Spectrum and the brand new book Gut Feelings: Healing the Shame-Fueled Relationship Between What You Eat and How You Feel.

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