Why Ulcerative Colitis Happens

It’s one of the most Googled questions about the condition. If you’ve just been diagnosed, or you’ve been living with it for a while and you’re still trying to join the dots, you’ve likely typed it too: Why does ulcerative colitis happen?

It’s a fair question. And the short answer? We don’t have one single answer. But that doesn’t mean we know nothing. In fact, we now know quite a lot. Enough to make sense of it – and to take meaningful action.

So let’s unpack the real reasons Ulcerative Colitis happens and why understanding the root causes (not just the symptoms) can completely change the way you manage the disease.

The Gut Health Triangle: A Foundation for Understanding UC

In my books, I talk about the three root causes that drive gut dysfunction: inflammation, leaky gut, and microbiome dysbiosis. I call this the gut health triangle. They each affect one another, and when they’re all out of balance, the immune system reacts.

In UC, that reaction is inflammation of the colon – but that inflammation isn’t just random. It’s your immune system sounding the alarm. Something is wrong. It’s trying to defend you.

This is important: Ulcerative Colitis is not caused by food, stress or antibiotics. But those things can worsen an already sensitive gut and create the conditions for symptoms or flares. Let’s break this down a little further.

Is UC Really an Autoimmune Disease? Why the Term Divides People

In many of the Ulcerative Colitis and Crohn’s support groups I’m in, the term “autoimmune” gets people heated. Some argue that it doesn’t make sense: why would the body turn on itself? Isn’t the body designed to heal? Isn’t it always trying to return to homeostasis?

I get it. And I agree with parts of that thinking. The body is trying to restore balance. But the term “autoimmune” simply describes what’s been observed: the immune system becomes dysregulated and starts attacking its own tissue. That’s what we see in Ulcerative Colitis – chronic inflammation in the colon, driven by an immune response.

The problem isn’t that the body is broken. It’s that it’s overwhelmed.

Environmental toxins, chronic stress, gut damage, microbial imbalances, infections – they all confuse and over-activate the immune system. And that constant activation leads to chronic inflammation.

In other words, it’s not the body turning on itself. It’s the body responding to a set of signals that it was never designed to handle.

So What Does Cause Ulcerative Colitis?

There is no single cause. It’s what we call multifactorial – a perfect storm of genetic predisposition and environmental triggers. Here are some of the big players:

• Microbiome imbalance (dysbiosis): A loss of microbial diversity or overgrowth of bad bacteria can disrupt immune regulation. Antibiotic use, diet, C-section births, and lack of fibre all affect this.

• Leaky gut (intestinal permeability): When the gut barrier weakens, unwanted particles pass through and trigger immune responses.

• Chronic inflammation: The result of all the above – the immune system goes into overdrive, damaging healthy tissue.

• Genetics: You might have a family history or a genetic vulnerability, but genetics alone do not cause UC.

• Stress: Not a root cause, but a known trigger for flares. Chronic stress alters gut motility, immunity, and microbiome diversity.

• Infections: Viral or bacterial infections (like gastro or food poisoning) can set off immune dysregulation in some people.

To put it simply, Ulcerative Colitis happens when your gut and immune system lose their balance. And once the cycle starts, it feeds itself. Inflammation creates more leaky gut. Leaky gut disrupts the microbiome. Dysbiosis triggers more inflammation.

That’s why healing has to be holistic.

Natural Ways to Support the Gut Health Triangle

Whether you’re in an active flare, coming out of one, or trying to stay in remission, there are powerful, natural tools that can support your gut at every stage. I always say that medication can be essential, but it’s not the full picture. You need to support your body’s ability to heal.

In an active flare, the focus needs to be on calming inflammation quickly. Natural supplements like high-quality curcumin (bioavailable and ideally enteric-coated or bioenhanced so that it is delivered to the colon directly - not systemically), Qing Dai (high quality), omega-3s, boswellia, and zinc carnosine have shown great promise here. These help cool the inflammatory fire without the long-term side effects of steroids – though if you’re on medication, always check for interactions, and be aware that Qing Dai specifically should not be used long-term (8-12 weeks maximum at high doses - and always have your liver enzymes checked before use for a base-line measure, and keep checking for signs of elevation).

As inflammation begins to settle, the next step is rebuilding. This means helping to repair the gut lining with nutrients like L-glutamine, butyrate (as tributyrin), and continued low-dose anti-inflammatories. This is also the time to reintroduce beneficial microbes – but not just any probiotic. Look for strains like Bifidobacterium longum BB536, Lactobacillus plantarum 299v, or spore-based probiotics like Bacillus coagulans – these are better tolerated and more effective for many with IBD.

Once you’re feeling stable, long-term gut maintenance becomes the goal. That’s where lower doses of those same gut-healing nutrients can keep the lining strong, inflammation in check, and your microbiome diverse. Daily support might include a combination of spore-based and lacto-bifido strains, prebiotic fibre (if tolerated), omega-3s, and vitamin D.

Across all stages, be mindful of quality, delivery, and synergy. Some people worsen on standard probiotics because the strains aren’t appropriate for their current microbiome state. Others don’t get results from anti-inflammatory herbs because the form isn’t bioavailable. This is why I’m so passionate about recommending solutions that work with the gut – not just adding another thing to swallow.

The Role of the Gut-Brain Axis

One of the most powerful connections we often overlook is the gut-brain axis. Your brain and your gut are in constant communication, and stress plays a massive role in that conversation.

Chronic stress doesn’t just make you feel anxious. It physically alters your gut. It reduces blood flow to the intestines, changes how you digest food, and even shifts the composition of your microbiome. Stress can make the gut barrier more permeable, increase inflammation, and flare symptoms.

If you're working on gut healing but still living in a high-stress, high-cortisol environment, it’s like trying to put out a fire with a watering can. This is why tools like breathwork, meditation, walking in nature, therapy, journaling – they’re not “nice extras”. They’re medicine.

Can Food Cause UC? No – But It Can Definitely Make It Worse

Food doesn’t cause UC, but the wrong food at the wrong time can absolutely worsen symptoms.

Processed food, low-fibre diets, artificial additives, emulsifiers – these can all disturb the microbiome, damage the gut lining, and create low-grade inflammation. In a healthy gut, your body might tolerate this for years. But what if your gut is already compromised? It becomes fuel for the fire.

That’s why identifying personal food triggers and supporting your microbiome with whole, anti-inflammatory foods is so key.

Here is a blog on 5 top gut-friendly foods. 

What About Medication? Where Does It Fit In?

It’s important to say: medication has a role. In many cases, it’s essential to stop active inflammation and prevent complications. But medication isn’t a cure. It doesn’t restore the microbiome or repair the gut lining. It suppresses symptoms. And while that can be life-saving and necessary, it also means we need to do more to support long-term remission.

This is where natural interventions matter. Rebuilding your gut, reducing toxic burden, improving your stress response – these are the areas that create resilience. They’re not a replacement for medical care. They work alongside it. (Read more about traditional medication on the Cleveland Clinic website.)

So Is There a Cure for Ulcerative Colitis?

The medical system will tell you there is no cure. And, technically, that’s true. There is no drug or surgery that guarantees UC will never return. But that doesn’t mean healing isn’t possible.

Drug-free remission is possible. I’m living proof, and so are many others. But it requires a multi-layered approach:

• Rebuild your microbiome

• Heal the gut lining

• Reduce inflammation

• Manage stress

  
  

Healing isn’t linear. But the body does respond. There is hope beyond symptoms. And remission doesn’t have to mean medication forever.

What Does the Future Hold? Emerging Research and Hope

We’re learning more every year. The future of UC management is likely to focus even more on:

• Microbiome therapies

• Gut barrier repair

• Immune modulation

• Personalised medicine

These areas are showing promise and will likely shape how we treat UC going forward. (Here’s a great summary from the NIH)

FAQs

Can ulcerative colitis be caused by stress alone?

No. Stress doesn’t cause UC, but it can trigger or worsen flares due to its impact on the gut-brain axis, immune function, and microbiome diversity.

Can you reverse UC with diet?

Diet can play a massive role in managing symptoms and reducing inflammation, but it’s not a cure on its own. It needs to be part of a broader gut healing strategy.

Is ulcerative colitis genetic?

There is a genetic component, but having a family history doesn’t guarantee you’ll get it. It usually takes a combination of genetic predisposition and environmental triggers.

What does the latest science say about UC?

New research is focusing on the microbiome, the role of intestinal permeability, and immune dysregulation. Studies suggest that future treatments might include microbiome transplants, immunomodulators, or targeted gut healing protocols. 

How long does it take to heal?

It depends on the severity of your condition, your triggers, and your approach. Some people see improvement in weeks, and others take months or years to reach remission.

Are there any natural treatments that really help?

Yes, but they must be used carefully and in the right context. Supplements like curcumin, Qing Dai, omega-3s, probiotics, butyrate, and L-glutamine have good research behind them – but always check for interactions with your medications first.

If you want to explore more on the gut health triangle, check out this blog: Your Gut Healing Roadmap: The 3 Pillars of a Thriving Digestive System

And if you’re ready to dive deeper into natural UC management, my book Well Now: Reclaim Your Life from Ulcerative Colitis is available on Amazon.

You deserve answers. And you deserve to feel well now.

This article is not a substitute for medical advice. Always work with a healthcare provider when making changes to your treatment plan.