Moderate to Severe
Ulcerative Colitis
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What is ulcerative colitis?
What does it mean for you?

Ulcerative colitis (UC) is a chronic and unpredictable disease.

UC is an inflammatory bowel disease (IBD) that affects the large intestine (colon and rectum). It differs from Crohn’s disease, which is also an inflammatory bowel disease. While Crohn’s can affect any part of the gastrointestinal (GI) tract from mouth to anus, UC affects only the large intestine.

Doctors perform tests to determine the location and type of ulcerative colitis. Symptoms may vary depending on the extent and severity of inflammation in the rectum and the colon.

Ulcerative colitis is often classified as an immune-mediated inflammatory disease.

When you have this type of disease, inflammation is due to an abnormal and prolonged response by your body's immune system. For people with ulcerative colitis, this inflammation occurs in the large intestine.


How do you get ulcerative colitis?

The exact cause is unknown.

Even though the cause of UC is not fully understood, it’s thought to be a result of a combination of factors:

Genetics

  • While several genes were found to be associated with UC, many people who carry these genes do not develop UC
  • About 20% of patients have a close relative with UC
  • Based on current research, there’s no way to predict which, if any, family members will develop it
  • The prevalence of UC is higher among white people of European origin and among people of Jewish heritage

Immune System

  • Researchers believe substances in the intestine are mistaken for invading substances (antigens)
  • To combat these antigens, your immune system causes temporary inflammation, which is reduced as you regain health
  • With UC, inflammation can persist long after your immune system should have finished its job

Environment

  • Immune responses in the large intestine can be due to exposure to foreign substances in the environment
  • Inflammation can also be triggered by microorganisms and intestinal bacteria
  • It's more common in urban than in rural areas
  • It's more common in northern than in southern climates
  • Certain foods can aggravate symptoms in some people, but there have been no studies to suggest that diet can either cause or treat ulcerative colitis
  • There’s no specific diet that patients with the disease should follow (although it’s always advisable to eat a balanced diet)
  • There’s no convincing evidence that ulcerative colitis results from food allergies

There are different types of UC, based on location. Learn about each.

Each type has its own specific set of symptoms and affects different areas of the large intestine.

Click on the different areas of the large intestine to see the types of UC and the symptoms associated with each.

Ulcerative Proctitis

Ulcerative proctitis affects the rectum. Symptoms can include rectal bleeding, rectal pain, and a feeling of urgency.

Proctosigmoiditis

Proctosigmoiditis affects the rectum and the sigmoid colon. Symptoms can include bloody diarrhea, pain in lower left side of abdomen, and constant feeling of need to pass stools (tenesmus).

Left-Sided Colitis

Left-sided colitis affects the rectum, sigmoid colon, and the left (or descending) colon. Symptoms can include bloody diarrhea, pain in left side of abdomen, and weight loss.

Pancolitis

Pancolitis affects the entire large intestine. Symptoms can include bloody diarrhea, severe abdominal pain, fatigue, and weight loss.

The Four Types of Ulcerative Colitis


Inflammation can lead to UC symptoms.

In UC, inflammation occurs in the large intestine (the rectum and the colon). Symptoms may vary depending on the extent and severity of inflammation in the large intestine. This can result in pain, diarrhea, and other symptoms of ulcerative colitis.

Common types of moderate to severe ulcerative colitis:

Pancolitis

  • Affects more than the left colon and often the entire colon
  • Symptoms include bouts of bloody diarrhea that may be severe, abdominal cramps and pain, fatigue, and significant weight loss

Ulcerative Proctitis

  • Inflammation is confined to the area closest to the rectum
  • Generally mild, typically treated with aminosalicylates, not biologics
  • Symptoms may include rectal bleeding (which may be the only sign of the disease), rectal pain, and a feeling of urgency

Proctosigmoiditis

  • Involves the rectum and the lower end of the colon
  • Symptoms include bloody diarrhea, abdominal cramps and pain, and constant feeling of need to pass stools (tenesmus)

Left-Sided Colitis

  • Inflammation extends from the rectum up through the sigmoid and descending colon (located in the upper-left part of the abdomen)
  • Symptoms include bloody diarrhea, abdominal cramps and pain on the left side, and unintended weight loss

Stay informed. It can help you ask the right questions.

There are several medications available to treat people with moderate to severe ulcerative colitis. So being well informed is an important first step toward finding a treatment that is right for you. Learning about your options and setting goals for your treatment can help you and your doctor make the best decisions about your care.

Learn About Treatment & Biologics

Your safety is important to us.
Learn about our Important Safety Information.

IMPORTANT SAFETY INFORMATION
ABOUT HUMIRA® (adalimumab)1

Next Page: Ulcerative Colitis Symptoms

What is the most important information I should know about HUMIRA?

You should discuss the potential benefits and risks of HUMIRA with your doctor. HUMIRA is a TNF blocker medicine that can lower the ability of your immune system to fight infections. You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay.

  • Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. Your doctor should test you for TB before starting HUMIRA, and check you closely for signs and symptoms of TB during treatment with HUMIRA. If your doctor feels you are at risk, you may be treated with medicine for TB.

  • Cancer. For children and adults taking TNF blockers, including HUMIRA, the chance of getting lymphoma or other cancers may increase. There have been cases of unusual cancers in children, teenagers, and young adults using TNF blockers. Some people have developed a rare type of cancer called hepatosplenic T-cell lymphoma. This type of cancer often results in death. If using TNF blockers including HUMIRA, your chance of getting two types of skin cancer (basal cell and squamous cell) may increase. These types are generally not life-threatening if treated; tell your doctor if you have a bump or open sore that doesn’t heal.


What should I tell my doctor BEFORE starting HUMIRA?

Tell your doctor about all of your health conditions, including if you:

  • Have an infection, are being treated for infection, or have symptoms of an infection
  • Get a lot of infections or infections that keep coming back
  • Have diabetes
  • Have TB or have been in close contact with someone with TB, or were born in, lived in, or traveled where there is more risk for getting TB
  • Live or have lived in an area (such as the Ohio and Mississippi River valleys) where there is an increased risk for getting certain kinds of fungal infections, such as histoplasmosis, coccidioidomycosis, or blastomycosis
  • Have or have had hepatitis B
  • Are scheduled for major surgery
  • Have or have had cancer
  • Have numbness or tingling or a nervous system disease such as multiple sclerosis or Guillain-Barré syndrome
  • Have or had heart failure
  • Have recently received or are scheduled to receive a vaccine. HUMIRA patients may receive vaccines, except for live vaccines
  • Are allergic to rubber, latex, or any HUMIRA ingredients
  • Are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed

Also tell your doctor about all the medicines you take. You should not take HUMIRA with ORENCIA® (abatacept), KINERET® (anakinra), REMICADE® (infliximab), ENBREL® (etanercept), CIMZIA® (certolizumab pegol), or SIMPONI® (golimumab). Tell your doctor if you have ever used RITUXAN® (rituximab), IMURAN® (azathioprine), or PURINETHOL® (mercaptopurine, 6-MP).


What should I watch for AFTER starting HUMIRA?

HUMIRA can cause serious side effects, including:

  • Serious infections. These include TB and infections caused by viruses, fungi, or bacteria. Symptoms related to TB include a cough, low-grade fever, weight loss, or loss of body fat and muscle.
  • Hepatitis B infection in carriers of the virus. Symptoms include muscle aches, feeling very tired, dark urine, skin or eyes that look yellow, little or no appetite, vomiting, clay-colored bowel movements, fever, chills, stomach discomfort, and skin rash.
  • Allergic reactions. Symptoms of a serious allergic reaction include hives, trouble breathing, and swelling of your face, eyes, lips, or mouth.
  • Nervous system problems. Signs and symptoms include numbness or tingling, problems with your vision, weakness in your arms or legs, and dizziness.
  • Blood problems. Symptoms include a fever that does not go away, bruising or bleeding very easily, or looking very pale.
  • Heart failure (new or worsening). Symptoms include shortness of breath, swelling of your ankles or feet, and sudden weight gain.
  • Immune reactions including a lupus-like syndrome. Symptoms include chest discomfort or pain that does not go away, shortness of breath, joint pain, or rash on your cheeks or arms that gets worse in the sun.
  • Liver problems. Symptoms include feeling very tired, skin or eyes that look yellow, poor appetite or vomiting, and pain on the right side of your stomach (abdomen).
  • Psoriasis (new or worsening). Symptoms include red scaly patches or raised bumps that are filled with pus.

Call your doctor or get medical care right away if you develop any of the above symptoms.


Common side effects of HUMIRA include injection site reactions (redness, rash, swelling, itching, or bruising), upper respiratory infections (sinus infections), headaches, rash, and nausea. These are not all of the possible side effects with HUMIRA. Tell your doctor if you have any side effect that bothers you or that does not go away.


Remember, tell your doctor right away if you have an infection or symptoms of an infection, including:

  • Fever, sweats, or chills
  • Muscle aches
  • Cough
  • Shortness of breath
  • Blood in phlegm
  • Weight loss
  • Warm, red, or painful skin or sores on your body
  • Diarrhea or stomach pain
  • Burning when you urinate
  • Urinating more often than normal
  • Feeling very tired

HUMIRA is given by injection under the skin.


This is the most important information to know about HUMIRA. For more information, talk to your health care provider.

 

Uses

 

HUMIRA is a prescription medicine used:

  • To reduce the signs and symptoms of:
    • Moderate to severe rheumatoid arthritis (RA) in adults. HUMIRA can be used alone, with methotrexate, or with certain other medicines. HUMIRA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
    • Moderate to severe polyarticular juvenile idiopathic arthritis (JIA) in children 2 years of age and older. HUMIRA can be used alone, with methotrexate, or with certain other medicines.
    • Psoriatic arthritis (PsA) in adults. HUMIRA can be used alone or with certain other medicines. HUMIRA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
    • Ankylosing spondylitis (AS) in adults.
    • Moderate to severe Crohn's disease (CD) and to achieve and maintain clinical remission in adults who have not responded well to conventional treatments. HUMIRA is also used to reduce signs and symptoms and to achieve clinical remission in these adults who have lost response to or are unable to tolerate infliximab.
    • Moderate to severe Crohn's disease (CD) and to achieve and maintain clinical remission in children 6 years of age and older when certain other treatments have not worked well enough.
  • In adults, to help get moderate to severe ulcerative colitis (UC) under control (induce remission) and keep it under control (sustain remission) when certain other medicines have not worked well enough. It is not known if HUMIRA is effective in people who stopped responding to or could not tolerate anti-TNF medicines.
  • To treat moderate to severe chronic plaque psoriasis (Ps) in adults who are ready for systemic therapy or phototherapy, and are under the care of a doctor who will decide if other systemic therapies are less appropriate.

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UC at a Glance

It's an inflammatory bowel disease
(IBD) that can affect the colon and
rectum, or the large intestine.

Common Symptoms

  • Diarrhea
  • Bloody stool
  • Abdominal pain

Causes

Exact causes are unknown, but are
believed to be a combination of factors, including:

  • Genetics
  • Environment
  • Immune System

Who's Affected

On average, most people are
diagnosed in their mid-30s.

  • Affects men and women equally
  • More prevalent among Caucasians
  • More common in urban areas

Please see the Full Prescribing Information, including the Medication Guide, for HUMIRA.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

If you cannot afford your medication, contact: www.pparx.org or call the toll-free phone number (1-888-4PPA-NOW) for assistance.

Please see accompanying full Prescribing Information, including Patient Instructions for Use in the Medication Guide and discuss it with your doctor.

Legal Notices/Privacy Policy. Copyright 2013, AbbVie Inc., North Chicago, Illinois, U.S.A. If you have any questions about AbbVie’s HUMIRA.com website that have not been answered click here. This website and the information contained herein is intended for use by US residents only, is provided for informational purposes only and is not intended to replace a discussion with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider and consider the unique characteristics of each patient.

Reference: 1. HUMIRA Injection [package insert]. North Chicago, IL: AbbVie Inc.

1299985-1211617

HUMIRA Use1

HUMIRA is a prescription medicine used in adults to help get moderate to severe ulcerative colitis under control (induce remission) and keep it under control (sustain remission) when certain other medicines have not worked well enough. It is not known if HUMIRA is effective in people who stopped responding to or could not tolerate anti-TNF medicines.

SAFETY CONSIDERATIONS1

Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. HUMIRA may increase the chance of getting lymphoma, including a rare kind, or other cancers. HUMIRA can cause serious side effects including hepatitis B infection in carriers of the virus, allergic reactions, nervous system problems, blood problems, heart failure, certain immune reactions including a lupus-like syndrome, liver problems, and new or worsening psoriasis.