Ulcerative colitis (UC) is a disorder of the large intestine resulting in inflammation, ulceration and bleeding. Symptoms can include diarrhea, increased stool frequency and urgency, abdominal and pelvic pain/cramping, and weight loss. It most commonly occurs in young adults or later in life and tends to be hereditary. The exact cause of UC is unknown. There is a broad spectrum of the disease from mild to severe rapidly progressive forms. The initial treatment is medications to reduce the inflammation and symptoms. Although this is often successful, some patients have chronic or refractory disease and may need to be considered for surgical referral. Chronic UC also increases the risk of colon cancer and close surveillance of the colon is indicated.