Internal Firestorm? Why Your Body Attacks Your Colon + Medically Approved Next Steps

If you've been told you have ulcerative colitis, or you suspect something isn't right with your digestion, you may be wondering: Why would my own body attack my colon?

It can feel confusing—and even frightening. But understanding what's happening inside your body can help you take clear, medically sound next steps.

Let's break it down in simple terms.

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What Is Ulcerative Colitis?

Ulcerative colitis is a chronic inflammatory bowel disease (IBD). It causes long-term inflammation and ulcers (sores) in the lining of the large intestine (colon) and rectum.

Unlike temporary stomach bugs or food poisoning, ulcerative colitis is an autoimmune condition. That means your immune system—designed to protect you from infection—mistakenly attacks healthy tissue in your colon.

This "internal firestorm" leads to ongoing inflammation. Over time, that inflammation can damage the lining of the colon and cause uncomfortable or serious symptoms.

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Why Does the Body Attack the Colon?

The short answer: we don't know exactly why.

The longer answer: it's likely caused by a mix of factors.

1. Immune System Misfire

In ulcerative colitis, the immune system becomes overactive. Instead of calming down after fighting germs, it continues attacking the colon lining.

This leads to:

• Swelling
• Ulcers
• Bleeding
• Mucus production

2. Genetics

Ulcerative colitis tends to run in families. If a close relative has inflammatory bowel disease, your risk is higher.

Researchers have identified certain genes linked to immune system regulation that may increase risk.

3. Environmental Triggers

While ulcerative colitis is not caused by stress or diet alone, certain environmental factors may contribute, such as:

• Changes in gut bacteria
• Certain infections
• Western-style diets high in processed foods
• Smoking cessation (interestingly, quitting smoking can sometimes trigger UC in predisposed individuals)

4. Gut Microbiome Imbalance

Your gut contains trillions of bacteria that normally live in balance. In people with ulcerative colitis, this balance may shift, triggering inflammation.

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Common Symptoms of Ulcerative Colitis

Symptoms can range from mild to severe. They may develop gradually or come on more quickly.

Common signs include:

• Frequent diarrhea
• Bloody stools
• Abdominal pain or cramping
• Urgency to have a bowel movement
• Feeling unable to fully empty bowels
• Fatigue
• Weight loss
• Fever (in more severe cases)

Some people also experience symptoms outside the colon, such as:

• Joint pain
• Skin rashes
• Eye inflammation
• Liver issues (rare but possible)

Symptoms often occur in cycles:

• Flare-ups (active inflammation)
• Remission (few or no symptoms)

If you're experiencing digestive symptoms and want to understand what might be causing them, try using a free AI-powered symptom checker for Ulcerative Colitis to get personalized insights before your doctor visit.

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How Serious Is Ulcerative Colitis?

Ulcerative colitis is a lifelong condition. It is not something that simply "goes away."

However, many people live full, active lives with proper treatment.

Without treatment, ulcerative colitis can lead to:

• Severe dehydration
• Significant blood loss (anemia)
• Colon rupture (rare but life-threatening)
• Increased risk of colon cancer over time
• Toxic megacolon (a medical emergency where the colon rapidly expands)

This is why early diagnosis and consistent medical care matter.

If you have severe abdominal pain, high fever, heavy rectal bleeding, or signs of dehydration, seek medical attention immediately.

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How Is Ulcerative Colitis Diagnosed?

A doctor will not diagnose ulcerative colitis based on symptoms alone. Diagnosis usually includes:

• Medical history and physical exam
• Blood tests (to check for anemia and inflammation)
• Stool tests (to rule out infection)
• Colonoscopy (the gold standard test)
• Biopsy (small tissue samples taken during colonoscopy)

A colonoscopy allows doctors to directly see inflammation and ulcers in the colon lining.

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Medically Approved Treatment Options

There is currently no cure for ulcerative colitis. The goal of treatment is to:

• Reduce inflammation
• Achieve remission
• Prevent flares
• Protect the colon long-term

Treatment depends on disease severity.

1. Anti-Inflammatory Medications

Often the first line of treatment:

• 5-ASA drugs (such as mesalamine)
• Corticosteroids (for short-term flare control)

2. Immune System Suppressors

These medications reduce immune overactivity:

• Azathioprine
• Biologic therapies (such as anti-TNF drugs)
• JAK inhibitors
• Integrin inhibitors

Biologics have significantly improved outcomes for many patients with moderate to severe ulcerative colitis.

3. Surgery

If medications do not control symptoms or complications arise, surgery may be recommended.

Surgical removal of the colon (colectomy) can effectively cure ulcerative colitis because the disease is limited to the colon. However, surgery is a major decision and typically reserved for severe or treatment-resistant cases.

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Lifestyle Changes That Support Treatment

Lifestyle changes do not replace medical treatment, but they can support it.

Nutrition

There is no single "ulcerative colitis diet," but helpful strategies may include:

• Eating smaller, more frequent meals
• Avoiding trigger foods during flares (spicy, high-fat, high-fiber foods)
• Staying hydrated
• Working with a registered dietitian

Stress Management

Stress does not cause ulcerative colitis, but it can worsen symptoms. Consider:

• Regular exercise
• Mindfulness practices
• Therapy or counseling
• Adequate sleep

Smoking

Unlike Crohn's disease, smoking sometimes appears to reduce ulcerative colitis symptoms. However, smoking carries serious health risks and is not recommended as treatment.

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Long-Term Outlook

With proper treatment, many people with ulcerative colitis achieve long periods of remission.

Important long-term care includes:

• Regular follow-ups with a gastroenterologist
• Colon cancer screening (typically starting 8–10 years after diagnosis)
• Monitoring medication side effects
• Staying up to date on vaccines (some medications suppress immunity)

Early and consistent management greatly reduces complications.

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When to Speak to a Doctor

You should speak to a doctor if you experience:

• Persistent diarrhea lasting more than a few days
• Blood in your stool
• Ongoing abdominal pain
• Unexplained weight loss
• Severe fatigue

Seek urgent care if you have:

• Heavy rectal bleeding
• High fever
• Severe abdominal swelling or pain
• Signs of dehydration

Ulcerative colitis can become serious if left untreated. Early intervention makes a meaningful difference.

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Final Thoughts

If it feels like your body is attacking itself, you're not imagining things. In ulcerative colitis, the immune system truly does misfire and target the colon.

But here's the important part:
This condition is manageable.

Modern treatments are more effective than ever before. Many people achieve remission and lead active, productive lives.

If you're unsure about your symptoms, starting with a free AI symptom checker for Ulcerative Colitis can help you identify patterns and prepare meaningful questions for your healthcare provider.

Then take the most important step: speak to a doctor. Only a qualified medical professional can properly diagnose ulcerative colitis and guide safe, effective treatment—especially if symptoms could be serious or life-threatening.

Understanding what's happening inside your body transforms fear into action. And action is how healing begins.