What Causes Ulcerative Colitis Flares?

uclersWhat causes Ulcerative Colitis (UC) flares is a mystery that University of Michigan researchers are working to solve.

It’s a challenging topic to study because flares can be unpredictable. We do know that when someone with Ulcerative Colitis has a specific infection, a Clostridium difficile infection, often called c.diff, they have a 50 percent chance of developing a flare in the next 180 days. We are studying why some people experience a flare and some do not.

C.diff infections are treated with antibiotics, which affect the normal diversity of bacteria in the gut. It’s believed that those who have flares do not reconstitute a normal level of bacteria in their gut after the treatment. Without that healthy balance of bacteria, they are more prone to a flare.

If we can determine exactly what is causing flares in this specific situation, we may be able to create a probiotic to help prevent those flares. We’re just getting started with this research and expect to be done in three years.

From the patient’s perspective, the research is fairly simple. It’s the timing that is critical. We take a stool sample the day the patient is diagnosed with c. diff, another sample when the antibiotic treatment ends, and a third sample two weeks later.

Deep microbial 454 sequencing (a kind of DNA sequencing analysis to identify which bacteria are present, and in what amount) is used to determine specific changes in the gut. Better understanding these changes can help us develop treatments or even preventative measures.

UC and Crohn’s disease are highly complex diseases involving more than 160 genes. Studying them to develop a better understanding of the causes and developing new treatments is important for the more than 1 million people in the U.S. who have these diseases.

This study is one of many we are participating in at the University of Michigan. This study is funded by the Crohn’s & Colitis Foundation of America.

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hig2.fwDr. Peter Higgins is a gastroenterologist at the University of Michigan Health System and the IBD editor for the American Journal of Gastroenterology. His research focuses on inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis. He is a member of the AGA IBD Quality Measures Committee, and has participated in the development of national guidelines for high quality IBD care.


HS_180x180The University of Michigan Digestive and Liver Health services is one of the largest programs in the country, providing prevention, diagnosis and treatment of diseases involving the gastrointestinal tract and liver. Our 60-plus physicians are experts in the diagnosis and treatment of all diseases of the gastrointestinal system.