Recognizing Ulcerative Colitis Symptoms

Quincy AdamUC Learn

Ulcerative Colitis Symptoms
Ulcerative colitis, a type of inflammatory bowel disease (IBD), causes inflammation and sores in your digestive tract.

Symptoms can range from mild to severe, depending on the degree of inflammation and where it’s located along your digestive tract. If you have limited inflammation in your rectum, you may have milder symptoms. If more parts of your colon are affected and inflammation is more severe, your symptoms may be worse.

Flare-ups and remission

Ulcerative colitis symptoms can be a little different for everyone, and some mimic many other illnesses. For example, abdominal pain and diarrhea could also be signs of a stomach virus or food poisoning. The symptoms of ulcerative colitis can come and go, so they can be somewhat confusing. You might, for example, think that you’ve gotten that same stomach virus again rather than something more severe.

Symptoms usually develop over time rather than occurring suddenly. You might have a flare-up of followed by long periods lasting months or years where you don’t have any symptoms at all. About five to ten percent of people with ulcerative colitis have constant symptoms.1

Over time, though, ulcerative colitis symptoms can multiply and keep recurring. Some symptoms are the result of having other severe symptoms over time. For example, if you have severe diarrhea for long enough, you might become dehydrated.

Most people with the disease develop mild to moderate symptoms. However, if you develop ulcerative colitis at a young age, you’re more likely to have severe ones.2

Common symptoms

The following are some common ulcerative colitis symptoms:

  • Diarrhea that’s often bloody or has pus. (This is the most common symptom.)
  • Frequent diarrhea, up to 10-20 times a day
  • Abdominal pain and cramping that can be severe
  • Rectal pain and bleeding
  • An urgent need to have a bowel movement
  • Painful bowel movements
  • Being unable to have a bowel movement in spite of feeling an urgent need to go
  • Fever—often low-grade and persistent due to the inflammation
  • Chills
  • Lack of appetite
  • Weight loss
  • Fatigue
  • Failure to grow (in children)
  • Anemia (Causes a reduction in red blood cells, which carry oxygen to your tissues. You may look pale and feel tired and weak.)
  • Dehydration (including weakness, feeling lightheaded, and producing less urine)
  • Skin lesions or sores
  • Persistent canker sores in your mouth (small, painful sores on the inside of your mouth, lips, or throat)
  • Joint pain or soreness
  • Eye problems such as iritis. This inflammation of the iris (the colored part of your eye around your pupil) can cause pain, redness, and sensitivity to light.
  • Liver disease

See Your Doctor

If you experience ulcerative colitis symptoms, it’s important to see your doctor so he or she can confirm a diagnosis of this disease and rule out other issues. He or she may need to do some of the following tests to confirm a diagnosis of ulcerative colitis and rule out other problems:

  • Stool (feces) sample
  • Colonoscopy or flexible sigmoidoscopy. These let your doctor look at parts of your colon using a flexible, lighted tube.
  • X-ray
  • CT scan

If your doctor diagnoses ulcerative colitis, you may also be prescribed an anti-inflammatory medication. You might also be asked to take pain medicines or anti-diarrhea medications to help you manage your symptoms. Be sure to discuss any other medications you may be taking with your doctor, as well as your diet and lifestyle. Each has an impact on your symptoms. Open communication between you and your health care provider will give you the best possible outcome in managing your care and reducing symptoms.

1 Osterman MT, Lichtenstein GR (2010). Ulcerative colitis. In M Feldman et al., eds., Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 9th ed., vol. 2, pp. 1975–2013. Philadelphia: Saunders Elsevier.
2 Available at: [Accessed April 21, 2015].