What are the symptoms of Ulcerative Colitis?

Understand Ulcerative Colitis symptoms—bloody stools, weight loss, cramping. GetWellGo helps international patients stay informed and seek expert care.

What are the symptoms of Ulcerative Colitis?

Colitis Symptoms

Colitis refers to the inflammation of the colon (large intestine). What causes trouble in the intestines depends on the type of colitis, yet most varieties share certain common symptoms.

Common Symptoms of Colitis:

They can be as mild as a headache or as severe as a full stroke, appearing all of a sudden or slowing forming over time.

Digestive Symptoms:

  • Diarrhea (that persists or occurs quickly)
  • Noticing blood in your stool or having mucous
  • The feeling of painful sensations in the abdomen
  • Bloating or having gas
  • Feeling that you have not fully passed stool
  • The need to go to the bathroom right away

Signs of Inflammation:

  • Fever
  • Fatigue
  • Losing weight can be a side effect of chronic colitis.
  • Not feeling like eating.

Serious symptoms:

  • Dehydration
  • Anemia is the result of blood loss.
  • Joint pain
  • Skin rashes or irritation inside the eye (mostly seen with ulcerative colitis or Crohn’s disease)

Symptoms of Ulcerative Colitis

The inflammatory bowel disease known as ulcerative colitis (UC) causes continued inflammation and ulcers on the inside of the colon and rectum. Most of the time, symptoms appear little by little and can come back, appearing in spurts called flares.

Ulcerative colitis flare-up symptoms:

Digestive Symptoms:

  • Regularly having diarrhea (which comes on all at once)
  • Blood that appears with your stool, mixed with mucus or pus
  • Lower left-sided pain and cramping.
  • Tenesmus involves continuous sensations of needing to have a bowel movement, even when you’ve already passed some stool
  • Urgency to have bowel movements
  • Mucus in stool.

General Symptoms:

  • Fatigue
  • Most commonly, during a flare-up (called fever).
  • A loss of appetite
  • Weight loss that is unintentional
  • Loss of water from diarrhea in the long term

Conditions not affecting the gastrointestinal tract

  • Discomfort involving the joints, accompanied by swelling
  • Rashes or sores on the skin
  • Mouth ulcers
  • Inflammation of the eye often causes pain, redness and a blurry perception.
  • Sometimes there are liver problems.

Early Signs of Ulcerative Colitis

The beginning of ulcerative colitis is slow and someone may at first mistake the symptoms for things like a poor reaction to food or an infection. Catching the initial symptoms early helps you get assessed and treated in time.

Most Common Early Signs of Ulcerative Colitis:

  • Persistent Diarrhea
  • Blood or Mucus in Stool
  • Urgent Need to Have a Bowel Movement
  • Abdominal Discomfort or Cramping
  • Tenesmus

Ulcerative Colitis vs Crohn’s disease Symptoms

Ulcerative Colitis

  • Ulcerative colitis only impacts the colon and rectum and inflammation happens all through the disease. 
  • The inflammation in ulcerative colitis takes place only on the inner surface of the colon and stays the same all along it. 
  • With ulcerative colitis, diarrhea is present, often including traces of blood and occur in haste, along with a many small bouts where a patient must defecate. 
  • Most people with ulcerative colitis feel pain in their lower left abdomen. This usually does not involve the stomach or upper intestines and it rarely leads to nausea. 
  • A main point of differentiation is the existence of anal complications. Fissures, fistulas and abscesses are usually not seen in ulcerative colitis around the anus. 
  • Having ulcerative colitis for a long time raises the risk of colorectal cancer, especially if the whole colon is affected.

Crohn’s disease

  • Although it can be found from the mouth to the anus, Crohn’s disease is usually affects the terminal ileum (end of the small intestine). 
  • One feature of Crohn’s disease is that healthy pieces of intestine are located between two areas of inflammation. 
  • Crohn’s can strike the entire thickness of the bowel wall and tends to appear in multiple small spots or patches. As a result of this severe inflammation in Crohn’s disease, people sometimes develop fistulas, narrowing in the colon known as strictures and abscesses.
  • Many people with Crohn’s disease develop diarrhea, not usually with blood, but with stomach pain on the lower right side and a bloated feeling. 
  • The loss of weight is typically greater in Crohn’s disease when there is malabsorption occurring in the small intestine. 
  • If the upper part of the digestive tract is affected, Crohn’s disease generally leads to nausea, vomiting and mouth ulcers. 
  • Cancer risks are raised by Crohn’s when it damages the colon, but the link is less strong. 
  • Almost always, the structural problems caused by Crohn’s such as strictures and blockages in the bowel, require surgery to be resolved. 
  • People with Crohn’s disease often experience a recurrence of the disease, even after they have surgery.

Stomach Pain from Ulcerative Colitis

Having pain in your stomach is typical for people with ulcerative colitis (UC). Here's a detailed explanation:

What the Pain feels like:

  • Most people say that the cramping or sharp pain in UC happens in the abdomen.
  • Cramps come on in waves, mainly when you have bowel activity.
  • Depending on how much inflammation happens, pain may be either gentle or very severe.

Where on the Body It Hurts:

  • The main symptoms are usually felt on the lower left side of the abdomen, as the lower colon is there.
  • When inflammation is widespread in the colon (pancolitis), the person may feel pain that affects a wider area of the abdomen.

Rectal Bleeding Ulcerative Colitis

In ulcerative colitis, there is swelling and sores on the colon and rectum lining called mucosa. The swollen tissue in hemorrhoids often breaks easily, so it can bleed when you go to the bathroom.

This bleeding occurs because:

  • Ulcers are found in the inside of the colon.
  • As stool moves through the body, the walls of weak blood vessels may tear.
  • Because it is very vascular and sensitive to inflammation, the rectum is commonly impacted in UC.

Ulcerative Colitis and Joint Pain

Sometimes, the inflammation of ulcerative colitis can reach other organs such as the joints. An overactive immune system leads it to attack the healthy parts in the joints.

Possible Joint Involvement in UC:

Peripheral Arthritis

  • It can cause problems in large joints like the knees, ankles, elbows and wrists.
  • Often it leads to temporary but does not cause long-term joint damage.
  • Changes in pain usually coincide with changes in bowel disease, getting worse when flares happen and improving during remission.
  • Most often it results in different joints on opposite sides being affected in different ways.

Axial Arthritis (Spondyloarthritis)

  • Deals with the spine and sacroiliac joints which are in the lower back and pelvis.
  • Can make your back feel stiff and cause ongoing pain when you wake up.
  • UC symptoms may come and go, but acne can still appear even if there aren’t any UC flare-ups.
  • Another connected condition is ankylosing spondylitis which brings on steadier inflammation and less flexibility in the spine.

Chronic Ulcerative Colitis Symptoms

Chronic ulcerative colitis is an ongoing bowel condition where the colon and rectum become inflamed, with periods of flares when symptoms worsen and then periods where symptoms disappear. The symptoms might not go away if the colitis is chronic and they can happen often, in waves or at times very badly, along with trouble outside the digestive tract.

Here’s what you might look for in chronic UC:

  • Chronic Diarrhea with Blood or Mucus
  • Abdominal Pain and Cramping
  • Frequent Bowel Movements
  • Fatigue and Weakness
  • Weight Loss and Poor Appetite
  • Low-Grade Fever (During Flares)
  • Joint pain or arthritis
  • Eye inflammation
  • Skin conditions
  • Liver issues
  • Anemia
  • Colon strictures
  • Increased risk of colorectal cancer
  • Toxic Megacolon