In Ulcerative Colitis (UC), the body starts to identify the GI tract as being foreign, and begins an inflammatory response that results in disease. Unlike Crohn's Disease, this inflammation does not involve all the layers of bowel, and it rarely spreads beyond the end of the large intestine. Often UC results in cramping with bloody diarrhea, but it doesn't produce tunnels (we call fistulas) between other organs or from bowel to skin. It typically starts in the rectum and moves up to various levels in the colon. Treatment involves special aspirin-like drugs, sometimes steroids, and drugs that suppress the immune system. Surgical removal of the colon is the cure of last resort. The disease increases the risk of colon cancer, so periodic colonoscopy for screening is important!