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AboutAboutTherapy Area OverviewRisk Factors of Ulcerative ColitisDiagnosingDiagnosingSigns and SymptomsComorbidities & PathophysiologyTreatmentTreatment guidelinesPfizer Treatment OptionsDisease NavigatorDisease NavigatorDisease NavigatorTreatmentTreatment guidelinesPfizer Treatment Options

Xeljanz®(tofacitinib citrate) Prescribing information and Inflectra®(infliximab) Prescribing information. Adverse event reporting can be found at the bottom of the page.

Comorbidities - Ulcerative Colitis

Ulcerative Colitis (UC) typically begins gradually and progresses for several weeks.1 Symptoms vary from person to person and can change over time as the disease progresses.2 Bloody diarrhea is the hallmark symptom of UC, but other gastrointestinal and general symptoms (also known as systemic symptoms) may also occur. 3-6

Intestinal Complications in UCGastrointestinal System2-4
  • Heavy, persistent diarrhea and pain
  • Severe bleeding 
    • Occurs in 10% of patients
    • Frequent cause of iron-deficiency anemia
  • Toxic megacolon
    • Rapid enlargement of the colon accompanied by fever, pain, and tenderness
    • May result in a perforation (a hole in the intestinal wall) with high risk of death
  • Stricture (narrowing of the intestine)
    • Uncommon in UC
  • Abnormal/enlarged tissues
  • Colorectal cancer
Extraintestinal Manifestations in UC

Complications outside of the GI tract, known as extraintestinal manifestations (EIMs), occur in up to 30% of patients with UC are associated with greater extent of disease and worse prognosis. These complications can either occur before the onset of UC symptoms or evolve at the same time.8



  • Painful inflammation
  • Redness
  • Tenderness




  • Ulcers (sores)




  • Tender, red bumps
  • Deep chronic ulcers (sores)




  • Primary sclerosing cholangitis (inflammation of the bile ducts)
  • Autoimmune liver disease


Joints and Bones


  • Osteoporosis
  • Arthritis
    • The most common EIM in patients with UC.9




  • Blood clots
  • Anemia


Risk Factors for Colorectal CancerRisk Factors for Colorectal Cancer

Patients with UC have an increased risk of colorectal cancer (CRC) that is associated with increased disease duration as well as the extent of the colon impacted by the disease.1-3

Long Disease Duration
  • The risk of CRC increases with disease duration.
Severe Inflammation
  • The risk of CRC is correlated with the severity of inflammation
Family History of CRC
  • A family history of CRC increases the risk of devloping CRC an additional 2-to-3-fold
Primary Sclerosing Cholangitis 
  • Primary sclerosing cholangitis is a condition characterised by chronic inflammation of the bile ducts; it is a common comorbid condition among patients with UC
Extensive Colon Involvement
  • The risk of CRC is increased 3.5-to-4-fold in patients with extensive colon involvement compared with those with proctitis who have little to no increased risk
Young Age at Onset
  • The risk of CRC is increased in patients diagnosed with UC before reaching 15 years of age.
Learning Academy
Inflammation Disease Navigator

Click below to view the Immuno-navigator tool. An interactive tool to help you manage discussions with your patients . 

Visit the Navigator Tool
Patient Support Materials (pdf)


Feuerstein JD, Cheifetz AS. Ulcerative colitis: epidemiology, diagnosis, and management. Mayo Clin Proc. 2014; 89(11):1553-1563.Ordás I. Eckmann L, Talamini M, Baumgart DC, Sandborn WJ. Ulcerative colitis. Lancet. 2012; 380:1606-1619.Danese S, Fiocchi C. Ulcerative colitis. N Engl J Med. 2011; 365:1713-1725.American Society for Gastrointestinal Endoscopy. Media backgrounder: endoscopic procedures. [Document on the Internet]. 2014 Aug 1 [cited 2016 Dec 13]. Available from: de Chambrun G, Peyrin-Biroulet L, Lémann M, Colombel J-F. Clinical implications of mucosal healing for the management of IBD. Nat Rev Gastroenterol Hepatol. 2010; 7(1):15-29.Neurath MF. Cytokines in inflammatory bowel disease. Nat Rev Immunol. 2014; 14(5):329-342.Crohn’s and Colitis Foundation of America. The facts about inflammatory bowel diseases. 2014. [Document on the Internet]. 2014 Jan 1 [cited 2016 Dec 14]. Available from: Silva BC, Lyra AC, Rocha R, Santana GO. Epidemiology, demographic characteristics and prognostic predictors of ulcerative colitis. World J Gastroenterol. 2014; 20(28):9458-9467.Vavricka SR, Rogler G, Gantenbein C. Chronological order of appearance of extraintestinal manifestations relative to the time of IBD diagnosis in the Swiss inflammatory bowel disease cohort. Inflamm Bowel Dis. 2015; 21(8):1794-1800.
PP-IFA-GBR-0634. July 2023

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