Is Ulcerative Colitis an Autoimmune Disease? Here’s the Need-to-Know

So, is ulcerative colitis an autoimmune disease?

Yep! Ulcerative colitis (UC) is widely classified as an autoimmune condition.

The Crohn’s and Colitis Foundation spells it out clearly by stating that UC is “the result of your immune system’s overactive response.”

Basically, an autoimmune disease = your immune system going rogue. Wires get crossed. Your body turns on itself, thinking that your normal, healthy cells are germy invaders. In the case of UC, the civil war = major inflammation and damage to the large intestine.

Does ulcerative colitis compromise the immune system?

Not exactly.

While the exact cause of UC is still unknown, we know that an overactive immune system — not weakened or compromised — plays a key role. Your immune system gets agitated and mistakes healthy tissue for foreign invaders.

That said, letting your UC run unchecked might eventually impede your immune system’s activity throughout the rest of your body.

Another plot twist: Some folks with UC have compromised immune systems because of the drugs they take to treat IBD. Immunosuppressants work by tamping down the damaging autoimmune response — but of course, that also dials down your overall immune system activity.

Here are some common UC meds that suppress your immune system:

• tacrolimus
• azathioprine
• cyclosporine
• 6-mercaptopurine

Uhm, does ulcerative colitis increase your COVID-19 risk?

Not necessarily.

A 2021 review of the data found that folks with IBD have the same risk of getting COVID-19 as anyone else. That’s good news, but remember that it doesn’t take your risk down to nothing.

Even the American College of Gastroenterology says folks who stick to their IBD treatment plan — yes, even immunomodulators — don’t have a heightened risk of getting COVID-19.

That’s all good, but what happens if you get COVID-19? Well, the same 2021 review found that

• Complications were less common for folks taking biologics for UC.
• Complications were prevalent for folks taking steroids or aminosalicylates (5-ASA).
• COVID-19 patients with UC had a higher risk of hospitalization (27 percent) and death (5 percent) than patients with Crohn’s disease.

Bottom line: Having UC doesn’t make you more likely to get COVID-19. But if you do catch COVID-19, you’re at a higher risk for complications and hospitalization.

So what’s up with UC and COVID-19 vaccines?

Good question!

First, in case you were wondering, mRNA vaccines (Pfizer and Moderna, represent!) do not cause UC. They also can’t cause COVID-19 because these nifty vaccines contain no live virus. Like, zero. Nada. Zilch.

Second, maybe you’re wondering if it’s OK for folks with UC to get the vaccine? Hell to the yes, says the Crohn’s and Colitis Foundation. While some UC treatments reduce the effectiveness of vaccines, it’s still safer to protect yourself a little than not at all.

While FDA-approved vaccines are considered safe if you have UC, it’s cool to wanna discuss this with a healthcare pro first. Discuss any questions or concerns with your personal doc — not a random person on TikTok, please — since they know your unique health history.

How to treat ulcerative colitis

Unfortunately, there’s no cure for ulcerative colitis. But there are treatments to soothe inflammation and curb the pain.

• Rx. Several types of meds are used to treat UC, including aminosalicylates, corticosteroids, immunomodulators, and biologics. Sometimes antibiotics are also prescribed.
• Surgery. If prescription meds don’t effectively soothe symptoms, your doctor might recommend surgical removal of your large intestine — aka a proctocolectomy.
• OTC symptom soothers. Some folks find relief with home remedies like probiotics and CBD. Your doc might also recommend pain relievers or antidiarrheal meds to cope with flare-ups.

Eating for ulcerative colitis

There’s still so much to learn about the causes and triggers of ulcerative colitis. But since it’s a gastrointestinal issue, what you eat can influence how you feel.

Working with a doc or dietician is the best way to nail down a UC-friendly diet, but there are a few common recommendations.

• Low FODMAP-diet. This diet requires you to cut back on foods with FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). The plan was designed to help calm IBS, but some folks with IBD (UC or Crohn’s) say it helps them too.
• Mediterranean diet. Research suggests that Mediterranean-style eating (lots of veggies, herbs, healthy fats, and some fish) can improve symptoms in folks with mild or moderate IBD.
• Low fiber foods. When your intestines feel shredded, the last thing you wanna do is poop. Experts recommend dialing down your fiber intake during UC flares.
• Gluten-free or lactose-free eating. OK, so these are not one-size-fits-all recommendations. Some folks with UC feel worse after eating gluten or dairy. An elimination diet can help you pinpoint your triggers to determine if cutting out one or both foods will help. (And if it doesn’t? Carry on with snacking on those low-fiber crackers topped with cottage cheese.)

Though everyone with UC has different triggers, lots of patients report issues with these foods:

• dairy
• alcohol
• red meat
• hot peppers
• artificial sweeteners
• sugary snacks and desserts
• sulfuric veggies (broccoli and cabbage, we’re lookin’ at you)

Sussing out the best diet for you takes time. Keeping a food diary and working closely with your doctor or dietician can help.

tl;dr

Though we still don’t know the cause of ulcerative colitis, most experts agree that it is an autoimmune disease.

Like other autoimmune diseases, ulcerative colitis occurs when the body’s immune system mistakes healthy tissue for foreign invaders. The result? Massive intestinal inflammation.

Immunomodulators are commonly prescribed for folks with ulcerative colitis. But there are other options too. Your doctor can help you form the best treatment plan for your situation, which might include a combo of meds and dietary changes.