Ulcerative colitis (UC) is one of the inflammatory bowel diseases of autoimmune origin. It is a chronic condition characterised by alternating periods of remission and exacerbation. In most patients, a mild to moderate form is observed, the effective management of which remains a significant clinical challenge, particularly in primary care settings. The aim of this expert consensus is to systematise knowledge regarding the diagnosis, therapy monitoring, and the role of primary care physicians in the therapeutic process of patients with UC. In particular, the authors present up-to-date treatment strategies and data on the efficacy and safety of various mesalazine formulations and budesonide MMX in this patient group. Special attention is given to the importance of adherence to therapeutic recommendations, which influences treatment efficacy, the optimisation of mesalazine dosing, the appropriate choice of drug formulation in specific patient populations, and the benefits of combination therapy. The document also discusses the use of non-invasive inflammatory markers, such as calprotectin, and the need for individualised therapy, especially during pregnancy and in elderly patients. Furthermore, the chemopreventive effect of mesalazine and the importance of endoscopic surveillance in colorectal cancer prevention are highlighted. The conclusions aim to standardise clinical practice and improve the quality of care for patients with UC.