To confirm a diagnosis of ulcerative colitis, most patients will need to have either flexible sigmoidoscopy or colonoscopy. Both procedures involve the use of a small movable camera and a light to view the insides of your large intestine. During either procedure, a biopsy may be done. In a biopsy, small samples of tissue are clipped from the lining of the intestine so that they can be examined under a microscope for signs of inflammation.
Because many temporary conditions, such as infections, cause the same symptoms as ulcerative colitis, your doctor will want to test your stool for other conditions that could explain your symptoms or make your symptoms worse. Tests for parasites and for bacterial infections will be done. Blood tests will be done to check for a low blood count or low iron levels, which can occur in ulcerative colitis. Blood tests also can help to detect inflammation. Blood tests should be done to check on your liver because inflammation of the liver ducts (called sclerosing cholangitis) occurs in some people with ulcerative colitis.
Ulcerative colitis is a lifelong condition, unless the large intestine is removed by surgery. Most people with ulcerative colitis do not choose to have their colon removed, because their symptoms can be controlled with medication or because they only have symptoms once in a while. In ulcerative colitis, the inflammation is not always active, so there can be long breaks between symptoms. Each time ulcerative colitis acts up, symptoms can occur for weeks or months. Often these flare-ups are separated by months or years of good health with no symptoms. Some people are able to identify triggers that aggravate their symptoms. By managing their diet, these people can increase the time between flare-ups.