Symptoms of Ulcerative Colitis (UC)

Symptoms of Ulcerative Colitis

Symptoms of ulcerative colitis include bloody diarrhea, abdominal cramps, fatigue, shortness of breath, joint pains, and weight loss.

The most common symptom that necessitates workup for ulcerative colitis is bloody diarrhea. Some patients may not notice blood but have long-standing diarrhea along with symptoms of anemia.

Uncommonly, some patients are diagnosed after they are being investigated for joint pains. Most such patients have arthritis of the spine, knees, hips, or shoulders. In addition, they have mild to moderate abdominal symptoms like abdominal pain, cramps, and diarrhea.

It is sometimes very difficult to differentiate clinically between ulcerative colitis and Crohn’s disease as both diseases can manifest with bloody diarrhea.

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What is Ulcerative Colitis?

A group of illnesses known as inflammatory bowel disease includes ulcerative colitis (IBD). It occurs when your rectum and the lining of your large intestine (also known as your colon or large intestines) get red and bloated (swollen).

Before extending to the entire colon, the inflammation often begins in your lower intestine and rectum.

Usually, ulcerative colitis does not affect the small intestine. The ileum, which is the lower part of your small intestine, may be affected.

do I have Crohn's disease or IBS?
Crohn’s disease or IBS

Your colon must empty itself frequently because of the inflammation’s diarrheal effects. Open sores (ulcers) develop as the colon’s lining’s cells deteriorate and fall off. These ulcers may bleed, and produce pus and mucus.

Ulcerative colitis typically begins between the ages of 15 and 30. Sometimes it affects older individuals and kids.

Both men and women are affected. Some families seem to be predisposed to it. A chronic (long-lasting) condition is ulcerative colitis.

On rare occasions, you may experience a remission lasting months or even years. But the symptoms will come back.

Symptoms of Ulcerative Colitis:

Abdominal pain:

The most frequent cause of cramps and pain in the abdomen is the UC’s inflammatory process. This type of inflammation usually begins in the rectum and spreads throughout the big intestine.

The more severe the pain, the bigger the inflammation. In contrast to typical abdominal pain, many with UC report a significant squeezing and releasing feeling that seems more like pressure.

Many patients have distal ulcerative colitis, which affects only their left side and causes inflammation and pain from the rectum to descending colon.

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Symptoms of IBS

Bloating and gas may accompany cramps, which can make your stomach feel tight and pressured. The severity of UC can be determined by the frequency and duration of cramping.

A moderate level of UC may be indicated by intermittent pain during bowel movements. On the other hand, persistent discomfort and bloody feces could indicate a more serious issue, like a dilated colon.

If you’re exhibiting specific symptoms, your present therapy is likely ineffective and you should think about switching to another type of therapy.

Call your physician if:

  • Cramping is severe.
  • You need to take medication because you have a lot of abdominal pain.
  • You develop a fever that lasts for several days.
  • You feel queasy and want to throw up.
  • You have frequent diarrhea or blood in your feces.
Symptoms of Crohn’s Disease
Symptoms of Crohn’s Disease

Rectal bleeding:

Blood can be seen in the stool when someone has ulcerative colitis because bleeding can occur from the rectum or large intestine lining.

The ulcers that have developed in the rectum or large intestine lining usually cause bleeding. The section of the large intestine that joins the rectum is called the sigmoid colon.

Blood and mucus can mix during or after bowel motions. The higher your UC travels in your large intestine, the looser your stools are going to be.

During an episode, you might have more than 10 bowel motions every day. Stools frequently contain solely blood and pus.

This bloody diarrhea sometimes coexists with stomach cramps, an unexpected urge to urinate, and even a fever.

Ozempic Diarrhea after eating
Ozempic Diarrhea after eating

Frequent diarrhea indicates that your colon must empty frequently. Each time, the organ’s lining cells shed.

Open sores are a result of this degradation. An anal fissure is another source of bleeding brought on by frequent bowel movements.

This is a rip in the lining of your anus that can be uncomfortable, especially when you poop. When wiping, you can notice bright red blood in your stool or on the tissue in the restroom.

You should contact your doctor immediately if:

  • You have frequent, severe diarrhea.
  • You see non-stop blood clots in your stool.
  • Your temperature increases.
  • You feel pain.
biologics for ulcerative colitis UC
Biologics for ulcerative colitis


Fatigue, an overwhelming sense of lethargy, and a lack of energy are all too frequently symptoms of ulcerative colitis.

If a person has ulcerative colitis, fatigue can significantly affect their ability to function at work and in their daily activities.

Numerous issues brought on by ulcerative colitis can leave you feeling extremely exhausted:

  • Your body runs out of fuel when you are unable to eat due to nausea and loss of appetite.
  • Your body has a difficult time absorbing the nutrients it requires for energy when you have diarrhea and colon enlargement.
  • Anemia, or having too few red blood cells, results from gastrointestinal bleeding.
  • You wake up frequently at night to use the restroom, which prevents you from getting adequate sleep.
  • You’re dehydrated as a result of your diarrhea.

Make sure to consume enough food and water to prevent fatigue and dehydration.

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Rectal pain:

Patients with ulcerative colitis frequently experience pain during bowel movements and at rest (UC).

The inflammation itself or altered mechanical characteristics of the rectum may be the source of the pain.

In many people, pain and urgency may cause incontinence, which is debilitating. Determining the mechanisms underlying the symptoms in UC is therefore of utmost importance.

Patients with both active and inactive illnesses have been found to have a stiffer rectal wall. This may partially explain the symptoms since gut stiffness will increase resistance to normal fecal and air passage in the afflicted segment, proximal dilatation, and pain and urgency as a result [Ref].

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Weight loss:

One prevalent sign of ulcerative colitis is weight loss. Losing weight is a sign of malnutrition brought on by a lack of calories to meet your demands.

This occurs for a variety of reasons, including:

  • Lack of appetite.
  • Food dislikes.
  • Malabsorption.
  • Your body will burn more calories while it fights the disease and its effects.
  • Nutrient losses are brought on by vomiting or bleeding in the intestines.


You may experience severe vitamin deficiencies and malnutrition as a result of ulcerative colitis, which can affect your body’s capacity to digest food and absorb nutrients.

Your body may have a harder time recovering from an illness if you are malnourished, even to a moderate degree.

Malnutrition symptoms include:

  • Undereating or drastically limiting the variety and types of foods consumed.
  • Loss of weight
  • General fatigue and reduced energy.
  • Muscular mass loss.
  • Mineral and vitamin insufficiency.
  • Weakness
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MRDM: Malnutrition-related Diabetes


Inflammation can make it difficult for the colon to handle food and waste. Additionally, it hinders the colon’s capacity to absorb water. The result is diarrhea, which is characterized by watery, loose feces.

Other symptoms of diarrhea caused by UC include:

  • Stomach ache and cramps, urgent need to go to the restroom.
  • Increased bowel movement frequency, including feeling like you, haven’t fully emptied your bowels at night.
  • Because UC can lead to ulcers in the rectum and colon lining, bloody diarrhea is frequently experienced.
  • Regular diarrhea can cause dehydration and other issues, such as weight loss.

Some other symptoms of ulcerative colitis

Additionally, ulcerative colitis may result in symptoms like;

  • Joint discomfort and edema.
  • High fever
  • Patches of painful, red, and puffy skin
  • Ulcers in mouth
  • Redness and swelling (inflammation) of the eyes.
  • Loss of blood (anemia) caused by severe bleeding.
  • Nausea and decreased appetite.

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Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

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