What are the symptoms of ulcerative colitis (UC)?

One symptom of ulcerative colitis (UC) is diarrhea. It happens because the gut can’t absorb water, so the water stays in the stool and makes it runny. The stool might even have blood, mucus or pus in it if there is a lot of damage in the gut. Diarrhea can cause cramps that can make going to the toilet painful, and the discomfort makes people run to the bathroom.

With ulcerative colitis, people might need to go to the bathroom a lot. It can also make people feel sick and not want to eat. Not eating well and losing blood can make people with UC feel tired.

Ulcerative colitis most often causes bloody diarrhea that doesn't stop, abdominal cramps and rectal bleeding (bleeding from the very end of the GI tract, right before the anus). Because of this bleeding, people with Crohn's disease may develop anemia (a loss of red blood cells resulting in extreme tiredness or fatigue). Other symptoms include nausea, vomiting, fever, weight loss (because the intestines may not be able to absorb enough nutrients from food), joint pain and skin problems.

The classic symptoms of ulcerative colitis are bloody diarrhea, which is a darker blood mixed within the stool. You may sometimes pass just pure blood or clots. (These symptoms are different from anorectal bleeding, which is usually a solid bowel movement with bright red blood when you wipe on the toilet paper, or the toilet water fills with redness. It's usually caused by hemorrhoids or fissures.)

Also, you may notice that you're passing some mucus, and that's because inflamed mucosa (the membrane lining the digestive tract) tends to shed a little bit of a mucoid layer. As a result, sometimes you may just pass mucus without having a bowel movement. Another classic feature of ulcerative colitis is rectal urgency, or dry heaves of the rectum. It's the urge to constantly have a bowel movement, whether or not you actually pass a stool. The reason rectal urgency is so common is because ulcerative colitis always starts at the bottom of your colon, the rectum, and moves upward.

Attached to the rectum is the anal sphincter, which opens and closes in response to distention from the rectum to allow the rectum to squeeze a stool out. If you have a lot of inflammation around your rectum, the sphincter may either be propped open or your rectum will require less stool to distend. Consequently, you may feel as though you need to go to the restroom all the time, even though not a lot of stool comes out.

You can oftentimes get abdominal cramping that may or may not be relieved by having a bowel movement. This is a result of the colonic inflammation. When you have more severe symptoms, you may start to develop systemic signs of inflammation. These include weight loss, a low blood count and fevers.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.