Ulcerative colitis is a condition involving chronic inflammation of the lining of the large intestine. It leads to the formation of small sores called ulcers that cause digestive symptoms and sometimes complications such as malnutrition.

Recent studies have helped scientists develop a better understanding of ulcerative colitis, including its potential causes and treatments.

Ongoing research may help them develop new strategies for preventing, diagnosing, and managing the condition.

Read on to learn about the latest research findings.

Gut microbes

The gastrointestinal tract contains more than 100 trillion microbial cells. Many microbes in this gut microbiome are “friendly” bacteria that help keep the body healthy. They influence metabolism, nutrition, immune function, and more.

Scientists have linked microbial disruption in the gut to several chronic conditions, including ulcerative colitis and other types of inflammatory bowel disease (IBD).

The authors of one 2020 studyTrusted Source from the Stanford University School of Medicine looked at the effect of colectomy with ileal pouch-anal anastomosis on gut microbes. Some people with ulcerative colitis undergo this operation to remove the damaged intestine.

The researchers found that people with ulcerative colitis who developed pouchitis after surgery had low levels of Ruminococcaceae bacteria in their digestive systems.

Pouchitis is ongoing intestinal inflammation that can occur after IBD surgery. According to the study authors, about 50% of people who undergo this procedure experience pouchitis.

People with pouchitis also had low levels of secondary bile acids (SBAs), anti-inflammatory substances that Ruminococcaceae bacteria produce.

The authors of the Stanford study hypothesized that low levels of Ruminococcaceae bacteria and SBAs in people with IBD may lead to increased inflammation that drives both IBD and pouchitis.

Past research has also found that people with IBD tend to have lower levels of SBAs than people without IBD.

The Stanford research team has an ongoing clinical trial to learn whether taking SBA supplements can reduce inflammation after surgery in people with ulcerative colitis. The estimated primary completion of this trial is December 2025, with an estimated study completion of December 2050.

Diet 

Scientists have not identified any single food or specific diet that causes, prevents, or treats ulcerative colitis.

However, some people with ulcerative colitis find that their symptoms improve when they eat or avoid certain foods. Different people may benefit from different diets.

Scientists have studied the effects of several diets on IBD, including:

• the Mediterranean diet, which is low in red meat and high in whole grains, vegetables, fruits, nuts, and monounsaturated fats
• the specific carbohydrate diet (SCD), which cuts out all grains
• the low FODMAP diet, which limits certain types of carbs
• a gluten-free diet, which eliminates wheat and other grains that contain gluten

The authors of a 2024 review of studies found some evidence that linked the Mediterranean diet to higher quality of life and lower disease activity in people with IBD. However, research findings on this diet were mixed.

According to the review, the SCD and modified SCD also show promise for reducing symptoms and disease activity in IBD. Most of the research into this diet has focused on children.

The review found that a low FODMAP diet does not appear to reduce disease activity in IBD. However, some evidence suggests that it might ease digestive systems in some people.

The review also found that some people with IBD report improved symptoms with the Crohn’s disease exclusion diet. This diet involves avoiding certain foods, such as gluten and dairy products. However, the studies were small, and more research is needed.

The researchers explained that some foods help support a diverse and healthy gut microbiome. They speculated that certain diets may help control inflammation in the gut to potentially prevent or help treat IBD.

The Mediterranean diet is filled with antioxidant-rich foods that research suggestsTrusted Source may help boost the gut microbiome and lower inflammation to reduce the risk of some chronic conditions. However, adherence to this diet is low.

The available research into diet for IBD is limited. More research is necessary to learn how various eating plans affect people with ulcerative colitis.

New and upcoming treatments 

In 2023, the Food and Drug Administration (FDA) approved the subcutaneous administration of vedolizumab (Entyvio) for maintenance therapy of moderate to severe ulcerative colitis after intravenous injections. This is the only FDA-approved biologic for maintenance therapy in ulcerative colitis that is available in intravenous (IV) and subcutaneous injections.

Entyvio is an integrin receptor antagonist that blocks the alpha4beta7 integrin, a specific type of receptor present in the gut. It is safe and effective for treating IBD, including ulcerative colitis, according to a 2022 reviewTrusted Source.

A 2020 study found that subcutaneous Entyvio is safe and effective as maintenance therapy for moderate to severe ulcerative colitis.

Scientists are also studying the treatment of ulcerative colitis with:

• JAK inhibitors
• interleukin-23 inhibitors, which are a type of biologic
• sphingosine 1 phosphate receptor modulators
• apremilast (Otezla)
• stem cell transplant
• fecal microbiota transplant

Some of these treatments may be effective for ulcerative colitis that does not respond well to current treatment options.

Researchers are continuing to study these treatments to learn how safe and effective they are for treating ulcerative colitis.

Biosensors

Healthcare professionals can better understand how active a person’s ulcerative colitis is by monitoring inflammation in their body. This information can help healthcare professionals determine whether it is necessary to adjust someone’s treatment plan.

To continuously monitor inflammation, scientists are developing and testing novel biosensors. These sensors use enzymes, antibodies, or other biological molecules to detect certain chemicals in the body.

For example, researchers from the University of Texas at Dallas have designed a wearable wrist device that monitors sweat for biomarkers of inflammation.

Scientists are also designing and testing ingestible biosensors. These are tiny detectors and transmitters that people swallow in capsules. Some ingestible biosensors detect gases or other chemicals that provide information about the health of the person’s digestive system.

Biosensors may eventually help people with ulcerative colitis get treatment earlier when inflammation increases or complications develop.

Genetics 

Scientists are also making progress in understanding the genetics of ulcerative colitis.

Most experts agree that the condition results from complex interactions among genetics, environmental factors, microbes, and immune responses.

Scientists have linked ulcerative colitis to more than 240 genetic variants, most of which are involved in the immune response.

Learning about the role that specific genes play may help scientists identify new treatment targets for ulcerative colitis. It may also help experts target the most beneficial available treatments to people based on their genetic makeup.

The takeaway

Researchers continue to study the underlying causes of ulcerative colitis, as well as novel strategies for diagnosing, monitoring, and treating the condition.

Ongoing studies may help experts develop new medications and tools for managing ulcerative colitis and learn which people are most likely to benefit from specific treatments.

People with ulcerative colitis can speak with a doctor to learn more about the new and experimental treatments for the condition.

Last medically reviewed on March 19, 2024

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