What Are the Symptoms of Ulcerative Colitis?

Medically Reviewed By Kelsey Trull, PA-C
Was this helpful?
597

Symptoms you may experience with ulcerative colitis (UC) can vary. Common symptoms include diarrhea, bloody stool, and abdominal pain. It is important to be aware of signs of a UC flare-up and more serious symptoms that may require medical attention. UC is a chronic inflammatory bowel disease. The symptoms of this condition occur due to inflammation and ulcers in the large intestine.

You are more likely to experience these symptoms if you are between the ages of 15 and 30, though they can occur at any time. Having a family history of UC may also increase your likelihood of developing the condition.

This guide explains some of the more common symptoms of UC. It also looks at what symptoms may require more urgent medical attention, what treatment options are available, and more.

What are the common symptoms of ulcerative colitis?

A person is lying down with their hand on their stomach.
Alba Vitta/Stocksy United

Common symptoms of ulcerative colitis (UC) include:

  • diarrhea
  • bloody stool
  • abdominal pain
  • an urgent need to pass stool
  • tenesmus, or feeling the need to pass stool even though the bowels are empty
  • passing pus or mucus in stool

Diarrhea

Recurring diarrhea is one of the main symptoms of UC, according to the U.K.’s National Health Service (NHS).

You may also experience diarrhea that contains blood, pus, or mucus.

Learn more about diarrhea.

Bloody stool

The majority of people with UC will experience rectal bleeding, according to the GI Society. The amount of blood in the stool can vary from person to person.

If you have bloody stool, you can usually notice the blood clearly, either on the surface of the stool or within the stool.

Rectal bleeding may lead to other symptoms, such as anemia if blood loss is severe.

Learn more about bloody stool.

Abdominal pain

Abdominal pain is one of the most frequent symptoms of UC, according to the Crohn’s & Colitis Foundation. You may also experience abdominal cramps.

Abdominal pain may be a symptom on its own, or you may experience it alongside symptoms such as diarrhea.

Learn more about abdominal pain.

Urgent need to pass stool

Some people with UC experience fecal urgency. This urgent need to pass stool is a common symptom of inflammatory bowel disease, according to 2018 research. It can occur with or without diarrhea.

In some cases, fecal urgency can develop into fecal incontinence.

Tenesmus

Tenesmus refers to feeling like you need to pass stool even though your bowel may be empty.

It can be a constant urge but it may also vary in severity.

Passing pus or mucus in stool

People with UC may often pass mucus or pus in their stool, according to the National Library of Medicine. This can occur alongside diarrhea or bloody stool.

It is important to be aware of any changes in your stool. Contact a doctor if you frequently pass blood, mucus, or pus in your stool.

Find out more about UC stool symptoms.

What are some more serious symptoms of ulcerative colitis?

Some symptoms can be a sign of more serious ulcerative colitis (UC).

More severe symptoms include:

It is important to contact a doctor as soon as you experience symptoms of UC.

What are the symptoms of an ulcerative colitis flare-up?

Alongside varying in severity, symptoms of ulcerative colitis (UC) may also come and go. Symptoms may persist, then disappear for weeks or years. This period without any symptoms is called remission.

In between periods of remission, you may experience UC flare-ups. You may have common symptoms of UC during a flare-up, as well as symptoms elsewhere in your body.

Symptoms of a UC flare-up may include:

  • swollen and painful joints
  • painful, swollen skin
  • irritated eyes
  • mouth ulcers

If you empty your bowel six or more times per day, it generally points to a more serious case of UC. Symptoms you may experience during a more severe flare-up include:

There is no single trigger for UC flare-ups. However, stress and stomach infections may contribute to a flare-up.

Can diet affect my ulcerative colitis symptoms?

Certain foods and drinks may trigger a flare-up or make your symptoms worse. Per the NHS, triggers may include:

  • foods high in fiber
  • foods and drinks containing caffeine
  • alcohol
  • fizzy drinks or sodas

Low fiber foods that may help to better manage symptoms during a flare-up include:

  • non-whole grain cereals, such as cornflakes
  • white bread
  • white rice
  • low fiber noodles and pasta
  • cooked vegetables without the peel, seeds, or stalks
  • eggs
  • lean meat and fish

Keeping a food diary can help you track which foods and drinks may trigger your symptoms. You should contact a doctor before you make any significant changes to your diet.

Do symptoms vary depending on the type of ulcerative colitis?

There are different types of ulcerative colitis (UC), and symptoms can vary depending on which type you have.

The main types of UC include:

  • ulcerative proctitis
  • left-sided colitis
  • extensive colitis

Ulcerative proctitis

Ulcerative proctitis causes inflammation in the rectum.

Symptoms you may experience with ulcerative proctitis include:

  • rectal bleeding
  • rectal pain
  • urgency during bowel movements

Left-sided colitis

Left-sided colitis refers to inflammation that begins in the rectum and extends to the splenic flexure. The splenic flexure is where the colon bends near the spleen.

Symptoms of left-sided colitis include:

  • bloody diarrhea
  • pain on the left side of your abdomen
  • unintentional weight loss
  • loss of appetite

You may experience proctosigmoiditis with left-sided colitis. Proctosigmoiditis is a type of UC that affects the rectum and sigmoid colon.

Extensive colitis

Extensive colitis, or pancolitis, is a type of UC that affects the whole colon. Inflammation usually begins in the rectum and extends past the splenic flexure.

Symptoms of extensive colitis can include:

When should I contact a doctor?

Contact a doctor as soon as you have concerns about ulcerative colitis (UC). It is also important to contact your doctor if you notice persistent changes in your bowel movements or if you pass a lot of blood in your stool.

What are the treatments for ulcerative colitis symptoms?

Your doctor may prescribe medication to treat your ulcerative colitis (UC) symptoms. If your symptoms do not respond to treatment or if you experience severe UC, they may recommend surgery.

Medications for ulcerative colitis symptoms

Medications your doctor may recommend include:

  • aminosalicylates, to reduce inflammation
  • corticosteroids, if your symptoms do not respond to aminosalicylates
  • immunosuppressants, for moderate to severe UC
  • biologics, to reduce inflammation

Learn more about treatment options for UC You can also find out more about managing your symptoms of UC.

Surgery for ulcerative colitis

Types of surgery you may require for UC include:

  • Proctocolectomy: During this procedure, a surgeon will remove your large intestine, according to the Crohn’s & Colitis Foundation.
  • Ileostomy: In this procedure, a surgeon will create an external ileostomy. This is when they attach the ileum, which is the end of the small intestine, to an opening in the abdominal wall.
  • Ileoanal reservoir surgery: During this procedure, a surgeon will create a pouch from the ileum and then attach it to the anus

Learn more about UC surgery.

How do doctors diagnose ulcerative colitis?

If you have symptoms of ulcerative colitis (UC), your doctor may take a full personal and medical history as well as carry out a physical examination.

They may then arrange for tests to confirm the cause of your symptoms. Possible tests include:

Find out more about how doctors diagnose UC. You can also learn about what to expect after a UC diagnosis.

Learn more

You can visit our main article on ulcerative colitis (UC) for an overview of the condition.

Please see the links below for more specific information about UC.

Summary

Symptoms of ulcerative colitis (UC) can vary depending on the type and severity of the condition. Common symptoms include diarrhea, bloody stool, abdominal pain, and fecal urgency.

If you have more serious UC, you may also experience symptoms such as fever, fatigue, weight loss, and loss of appetite.

It is important to contact your doctor as soon as you experience symptoms of UC. They will be able to carry out tests to reach an accurate diagnosis and advise you on the best treatments to help you to manage your symptoms.

Was this helpful?
597
Medical Reviewer: Kelsey Trull, PA-C
Last Review Date: 2022 Aug 30
View All Ulcerative Colitis Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Overview of ulcerative colitis. (n.d.). https://www.crohnscolitisfoundation.org/what-is-ulcerative-colitis/overview
  2. Overview: Ulcerative colitis. (2019). https://www.nhs.uk/conditions/ulcerative-colitis/
  3. Rangan, V., et al. (2018). Risk factors for fecal urgency among individuals with and without diarrhea, based on data from the national health and nutrition examination survey. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6098738/
  4. Ulcerative colitis. (n.d.). https://badgut.org/information-centre/a-z-digestive-topics/ulcerative-colitis/
  5. Ulcerative colitis. (n.d.). https://medlineplus.gov/genetics/condition/ulcerative-colitis/
  6. Ulcerative colitis. (n.d.). https://www.niddk.nih.gov/health-information/digestive-diseases/ulcerative-colitis