Ulcerative Colitis: Causes, Symptoms, Types and Ayurvedic Management

Abstract

Ulcerative colitis (UC) is a type of chronic inflammatory bowel disease that causes inflammation in the lining of the colon and rectum, and the development of ulcers. The cause of ulcerative colitis is not properly known. It is thought to occur because of an overactive immune system, along with genetic and environmental influences. The symptoms vary from mild to severe, which include frequent stomach cramps, diarrhea, sometimes with blood or mucus, weight loss, fatigue, and an urgent need to use the washroom.

For the diagnosis of ulcerative colitis, healthcare providers perform multiple evaluations to assess the condition. These include stool tests to rule out infection, blood tests to check the overall signs of inflammation or anemia, and a colonoscopic evaluation is carried out to identify inflammatory lesions within the colorectal tract. Treatment in Ayurveda targets the underlying imbalance of doshas, offering varied approaches to restore normal digestive and systemic function. The focus is on modulating inflammation, improving gastrointestinal function, and restoring mucosal integrity. This article mainly focuses on causes, symptoms, diagnosis, treatment (according to modern terminology), and ayurvedic review of ulcerative colitis diseases and herbal remedies, and also the ayurvedic treatment for these diseases.

Introduction

Inflammatory Bowel Disease is an immune-mediated chronic inflammatory bowel disease. Ulcerative Colitis and Crohn’s Disease are two major types of inflammatory bowel disease. It is a mucosal disease that usually involves the rectum and extends proximally to involve all parts of the colon, leading to inflammation and ulceration of the intestinal lining. Ulcerative colitis is considered an autoimmune condition in which the body’s immune system attacks the cells of the large intestine. In more severe diseases, the mucosa is hemorrhagic and ulcerated. The exact cause of ulcerative colitis remains unclear. The disease can significantly impact the quality of life of affected individuals, causing emotional distress, social isolation, and economic burden. The cases of ulcerative colitis are increasing day by day in developing countries, making it a public health concern amongst all.

Causes

Ulcerative colitis is an autoimmune disease, so there is no particular cause for this condition. However, research suggests that it is a complex interplay, but there are some risk factors, such as –

• Genetic factors – If someone in the family already has ulcerative colitis, then this condition is more likely to develop.
• Immune system dysfunction – Ulcerative colitis may happen when the body’s immune system mistakenly attacks healthy tissues in the colon, which causes inflammation.
• Environmental factors – Things like diet and infections can cause ulcerative colitis in people who are genetically at risk.
• Diet – Diets low in fiber and high in fats are linked with an increased risk of ulcerative colitis.
• Age – Ulcerative colitis mainly develops in young adults between 15–30 years of age, with a lower risk in older adults.
• Psychological stress – Stress may trigger or worsen symptoms in affected individuals.

Types

Ulcerative colitis can be classified into four main types based on the extent and location of inflammation.

1. Ulcerative Proctitis

Location – Inflammation is limited to the rectum.

Symptoms – Rectal bleeding, urgency, mild discomfort or pain in the lower abdominal region.

Severity – Mildest form.

2. Proctosigmoiditis

Location – Affects the rectum and sigmoid colon.

Symptoms – Diarrhea, blood in stool, cramps, urgency, and incomplete evacuation.

Severity – Moderate and manageable with medications.

3. Left-Sided Colitis (Distal Colitis)

Location – Affects the descending and sigmoid colon.

Symptoms – Bloody diarrhea, mucus, and left-sided abdominal pain.

Severity – More severe but usually manageable.

4. Pancolitis

Location – Affects the entire colon.

Symptoms – Frequent bloody stools, severe abdominal cramps, urgency, weight loss, fever, and fatigue.

Severity – Most severe type.

Signs And Symptoms

• Diarrhea with blood, mucus, or pus
• Stomach ache and cramps
• Rectal pain
• Unintentional weight loss
• Weakness and fatigue
• Fever
• Bloating
• Redness and itching in the anal region
• Nausea and vomiting
• Urgency to defecate

Ulcerative Colitis Flare-Ups

Ulcerative colitis flare-ups occur when symptoms worsen, including increased diarrhea, abdominal pain, rectal bleeding, urgency, and fatigue. These flare-ups may be triggered by stress, certain foods, infections, or missed medications. Management includes medication adjustments, avoiding trigger foods, hydration, and stress-reducing practices such as yoga and meditation.

Diagnosis

• Assessment of symptoms
• Physical examination
• Blood tests – CRP, ESR (elevated), Hemoglobin or Hematocrit (low)
• Stool tests – Stool culture, fecal calprotectin (elevated)
• Imaging techniques – CT scan, colonoscopy

Management Of Ulcerative Colitis

• Avoid greasy and high-fiber foods
• Limit sugary, carbonated, and alcoholic beverages
• Maintain a food diary
• Eat smaller meals frequently
• Limit dairy intake
• Practice yoga and meditation
• Follow prescribed medications regularly
• Use corticosteroids, antibiotics, immunosuppressants, and probiotics as advised

Ayurvedic Aspect Of Ulcerative Colitis

From an Ayurvedic perspective, Ulcerative Colitis is considered a disease of the digestive system, especially affecting the colon. In Ayurveda, Pittaatisara (diarrhea caused by the vitiation of Pitta dosha) is a condition that shares similarities with ulcerative colitis, and with severity, this Pittaatisara (diarrhea caused by the vitiation of Pitta dosha) is converted into raktajatisara. Both involve symptoms such as bloody diarrhea, abdominal pain, and inflammation in the anorectal region, which are often linked to ulcerations of the colon and rectal mucosa.

According to Acharya Charaka, individuals with Pittatisara (diarrhea with frequent, hot, foul-smelling stools), caused by an imbalance in the Pitta dosha, are at risk of developing Raktatisara if they fail to follow Pathya Aahara (proper dietary) and Vihara (lifestyle) practices. In the treatment of all types of atisara (diarrhea), it is important to first assess whether the condition is linked to Apakva (undigested food) or Pakva (properly digested food). This assessment is crucial in determining the right course of treatment. The treatment plan may include Agni Dipana (boosting digestive strength), Ama Pachana (clearing undigested food), Grahi (managing diarrhea), Stambhana (controlling bleeding), Dhatu Poshaka (nourishing the tissues), and Sattvavajaya Chikitsa (providing psychological support).

Nidana (Causative Factors)

• Amla (sour), Lavaṇa (salty), and Katu (pungent) rasa pradhana ahara (food)
• Ushan (hot) and Tīksna (sharp) ahara (food)
• Vidahi anna-pana (foods and drinks causing a burning sensation)
• Kshara sevana (use of alkaline or irritating substances)
• Madyapana (drinking alcohol)
• Viruddhahara sevana (incompatible food intake)
• Ajeerna bhojana (Indigestion food)
• Atapa sevana (exposure to sunlight)
• Vyayama ati sevana (doing excessive physical activity)
• Krodha (Anger)
• Mental agitation (Stress and frustration)
• Agnimandya (Weak digestive fire)
• Ama sanchaya (accumulation of toxins in the body)

Purvroopa (Premonitory Symptoms)

• Hridya, nabhi, guda, udar, kukshi peeda (pain in the heart, umbilicus, anal, abdomen, and flank region)
• Anga shithilata (weakness of body parts)
• Adhovayu avrodha (downward movement of air obstruction)
• Adhmana (bloating)
• Bhojan avipaka (improper digestion of food material)

Roop (Symptoms)

• Pittaa varna mala pravritti (passage of yellowish color stool)
• Drava mala pravritti (frequent watery stools)
• Guda Daha (burning sensation in the anal region)
• Tīkshana gandha yukta mala (pungent and foul odor stool)
• Trishna (excessive thirst)
• Shoola (pain)
• Klama (weakness and fatigue)
• Murchha and Bhrama (fainting and dizziness)

Samprapti (Pathogenesis)

Exposure to etiological factors results in an aggravation of Pitta dosha. The increased heat and liquidity. Once aggravated, Pitta suppresses the Agni (digestive fire) and then relocates to the Pakvasaya (colon) to exert its pathogenic influence. In this stage, the Ushan (hot) and Sara (mobile) qualities of Pitta act on the fecal matter, causing enhanced liquefying action and stool breakup. This presents clinically as loose, yellowish-green, foul stools, along with burning discomfort, intense thirst, and sometimes contamination with blood or bile.

If Pittaja Atisara is not treated properly and the condition persists, then Pitta further provokes Rakta Dhatu (blood tissue) and causes Raktaj Atisara (blood in stool).

Herbal Remedies For Ulcerative Colitis By Planet Ayurveda

Planet Ayurveda is a renowned Ayurvedic healthcare organization committed to restoring health through the principles of ancient Ayurvedic science. Established by Dr. Vikram Chauhan (MD–Ayurveda), it specializes in the production of 100% natural and vegetarian herbal formulations prepared from standardized extracts of medicinal plants. All products are manufactured under GMP-certified conditions and are free from chemicals, preservatives, and artificial additives, ensuring complete purity and safety. Planet Ayurveda’s formulations are based on classical Ayurvedic texts and are designed to balance the three Doshas — Vata, Pitta, and Kapha. The company provides expert Ayurvedic consultations, authentic herbal remedies, and holistic treatment protocols for various health conditions, including lifestyle disorders, autoimmune diseases, and metabolic imbalances. With a global presence across countries, Planet Ayurveda continues to promote natural healing and the timeless wisdom of Ayurveda worldwide.

Ulcerative Colitis Care Pack

1. Arjuna Capsules
2. Vatsakadi Churna
3. Pitta Balance
4. Kutajghan Vati

Product Description

1. Arjuna Capsule

Arjuna (Terminalia arjuna) Capsule is a herbal formulation prepared from pure Terminalia arjuna bark extract, offering noticeable support in Ulcerative Colitis due to its cooling, natural binder, and healing properties. Arjuna helps reduce inflammation of the colon, control rectal bleeding, and promote faster healing. The tannins and antioxidants create a natural protective coating on the gut mucosa, calming inflammation and limiting additional damage. By calming aggravated Pitta and strengthening gut tissues, Arjuna helps reduce burning sensations, watery stools, and abdominal discomfort, making it useful during active flare-ups and healing phases.

Dosage – 2 capsules twice a day with water after a meal.

2. Vatsakadi Churna

Vatsakadi (Holarrhena antidysenterica) Churna is a classical herbal powder used to support conditions such as IBS, Ulcerative Colitis, and chronic diarrhea. It contains Kutaj, Bilva, Saunf, Dhania, Anar, and Choti Elaichi, which help restore normal intestinal function. Kutaj provides anti-inflammatory and anti-diarrheal effects, Bilva and Saunf reduce abdominal cramping, while Anar and Elaichi soothe Pitta irritation and promote colon healing. The formulation controls loose stools, improves digestion, and reduces abdominal discomfort.

Dosage – 1 tablespoon twice daily with water after a meal or boil 1 tablespoon in 400 ml water and reduce to 50 ml.

3. Pitta Balance

Pitta Balance is a herbal-mineral formulation designed to regulate aggravated Pitta Dosha. It contains Jahar Mohra Pishti, Akik Pishti, Praval Pishti, Giloy Satva, and Kamdudha Ras. It helps reduce inflammation, control bleeding, soothe burning sensation, regulate Agni, restore mucosal strength, and prevent flare-ups.

Dosage – 1 capsule twice daily with water after a meal.

4. Kutajghan Vati

Kutajghan Vati is prepared from the bark of Holarrhena antidysenterica (Kutaj), known for its anti-inflammatory, anti-diarrheal, and antimicrobial properties. It is beneficial in Grahani, Atisara, and intestinal irritation. It helps control diarrhea, reduce rectal bleeding, calm Pitta, strengthen digestion, and restore gut mucosa.

Dosage – 2 tablets twice daily with water after a meal.

Conclusion

This article concludes that ulcerative colitis is a chronic inflammatory bowel disease involving ulceration of the colon and rectum. Although the exact cause is unknown, genetic and environmental factors play a major role. Common symptoms include bloody diarrhea, abdominal pain, and loss of appetite. Diagnosis involves blood and stool tests, while Ayurveda focuses on correcting doshic imbalance. Herbal remedies by Planet Ayurveda provide supportive and holistic management with ayurvedic medicines ulcerative colitis.