Ulcerative colitis and multiple sclerosis are two autoimmune conditions. People with ulcerative colitis may be at an increased risk of multiple sclerosis, but the opposite doesn’t seem to be true.

Ulcerative colitis (UC) is a type of inflammatory bowel disease characterized by open sores in the digestive tract. It typically causes gastrointestinal symptoms like:

  • diarrhea, which may be bloody
  • abdominal pain
  • fatigue

Multiple sclerosis (MS) is a neurological disorder characterized by the breakdown of myelin, the protective sheath that covers nerve cells in the brain and spinal cord.

It’s well-established that people with UC have an increased risk of MS. It’s thought that multiple factors may play a role in this connection, such as shared genetic factors and increased inflammation throughout the body.

Continue reading to learn more about these two autoimmune conditions.

Research has established a strong connection between UC and MS.

In a 2023 review of available research, researchers estimated that UC likely increased the risk of developing MS by more than 50%. However, they didn’t find evidence that the opposite was true.

A 2023 review found a slightly increased risk of UC in people with MS, but the link didn’t reach statistical significance.

Many other studies have also reported an increased risk of MS in people with UC or another type of inflammatory bowel disease (IBD) called Crohn’s disease.

In a 2022 review, researchers reported MS in 0.2% of people with IBD. They reported IBD in 0.6% of people with MS.

In a 2024 study of 24,934 people from Germany, researchers reported MS in 0.9% and 0.7% of people with Crohn’s disease and UC, respectively, over 10 years, compared to only 0.5% and 0.3% in people without IBD.

Shared genetic factors

The exact genetic cause of MS and UC remains unclear. A combination of genes and environmental factors likely play a role in developing both conditions.

One possible explanation of why research more consistently links UC to an increased risk of MS is that shared genetic factors more strongly contribute in this direction.

In a 2021 study, researchers reported three genetic factors that linked MS to people with IBD. They found inconsistent evidence for a causal effect of MS on UC.

Ulcerative colitis and inflammation

UC can cause inflammation in your gut and disruptions in your microbiome that may promote inflammation throughout your body.

Several of the immune cells activated in inflammatory pathways in people with UC are also thought to promote the degeneration of nerves in your central nervous system, which is made up of your brain and spinal cord.

UC and MS may share some risk factors, such as:

Here are some of the symptoms of UC and MS.

Ulcerative colitis symptoms

UC symptoms can include:

Multiple sclerosis symptoms

Symptoms of MS can vary significantly between people but can include:

  • vision problems
  • numbness or tingling in your limbs, trunk, or face
  • cognitive changes
  • bladder control problems
  • trouble walking
  • trouble with other movements

Learn more about MS symptoms.

Here’s a look at the potential causes of UC and MS.

Ulcerative colitis causes

UC seems to run in families. A combination of genetic factors and environmental exposures likely both play a role in its development.

Multiple sclerosis causes

Like UC, MS can run in families, but more than 200 genes are thought to play a role in its development. You can develop MS with or without a family history.

To start the diagnostic process for either condition, a doctor will start by asking you about your:

  • personal medical history
  • family medical history
  • symptoms

They will also perform a physical exam to look for characteristic symptoms. If they suspect UC, you may receive:

If your doctor suspects MS, you might receive:

  • MRI scans
  • spinal fluid analysis
  • evoked potential test to measure electrical activity in your brain and spinal cord

It’s important to get medical attention if you suspect you may have UC or MS. Symptoms of both conditions are often general but may get worse over time. Receiving a proper diagnosis and treatment can help you minimize the course of the disease and avoid complications.

Treatment for both conditions aims to manage inflammation and prevent disease progression. Common medications prescribed to treat both conditions include:

  • corticosteroids
  • immunomodulators
  • immunosuppressants
  • monoclonal antibodies

Other treatments specific to UC include aminosalicylates and TNF inhibitors.

The risk of developing MS appears to be increased in people with UC, but there’s less evidence that the opposite correlation is true. The increased risk might be related to genetic factors and increased inflammation throughout your body.

It’s important to seek prompt medical attention if you suspect you may have either condition for a prompt diagnosis and treatment. The most common treatment options for UC are medications or surgery. Treatment for MS usually involves taking medications.