What Are the Symptoms of Ulcerative Colitis?

A woman with ulcerative colitis holds her stomach in pain while lying on a sofa — Photo Courtesy: Adobe Images

Millions of people worldwide live with ulcerative colitis, a chronic inflammatory bowel disease (IBD). A chronic disease usually lasts three months or longer and may worsen over time. It can be scary to get a chronic disease diagnosis like ulcerative colitis. The symptoms can significantly impact an individual's quality of life. However, it’s important to remember that you can still live a full life once you know the signs and symptoms and how to manage them.

Ulcerative colitis shares symptoms with Crohn’s disease, which is also an IBD. There are also key differences between the two. When someone exhibits features of both ulcerative colitis and Crohn’s disease, it is known as indeterminate colitis. Here’s what you need to know about ulcerative colitis, its symptoms, and treatment options.

What is ulcerative colitis?

Ulcerative colitis occurs in the large intestine (colon) and rectum. Medical professionals believe it is the result of an overactive immune system response. This abnormal response causes the lining of the colon to become inflamed and develop open sores, known as ulcers.

Other factors that can contribute to ulcerative colitis include genetics, microbiome, and environmental factors. People with a family history are also more likely to develop ulcerative colitis. However, it isn’t possible to predict which, if any, family members will develop the disease.

More than 750,000 people in North America are estimated to live with ulcerative colitis. It is more common in white persons and people of Eastern and Central European Jewish descent. Although ulcerative colitis can affect anyone at any age, most people are diagnosed in their mid-30s. Older men are more likely to be diagnosed with ulcerative colitis than older women.

How is ulcerative colitis different from Crohn’s disease?

Unlike ulcerative colitis, Crohn’s disease can affect any part of the gastrointestinal (GI) tract. The GI tract runs from the mouth to the anus. Crohn’s usually affects the portion of the small intestine before the colon. It can also skip portions of the bowel before appearing in others. Ulcerative colitis, on the other hand, usually starts from the rectum and spreads continuously to the rest of the colon.

With ulcerative colitis, only the colon's innermost lining, called the mucosa, becomes inflamed. With Crohn’s disease, inflammation doesn’t stop at the mucosa. It can go through the wall of the intestines and cause pus-filled pockets of infection called abscesses. Crohn’s can create tunnels, known as fistulas, between two organs or an organ and the outside of the body. These can also become infected.

What are the symptoms of ulcerative colitis?

The symptoms of ulcerative colitis can vary from person to person. About half of people with ulcerative colitis will have mild symptoms. Common symptoms of ulcerative colitis include:

Abdominal pain and cramping
Diarrhea or urgent bowel movements
Bloody stool
Mucus or pus in the stool

There are also less common symptoms that can occur with severe ulcerative colitis. These symptoms include:

Fever
Fatigue
Weight loss
Nausea or vomiting

Ulcerative colitis symptoms can come and go. The periods when you have symptoms are called flares or flare-ups. When you don’t have symptoms, you are in remission. Some periods of remission can last several months or even years. There is no cure for ulcerative colitis yet, so the symptoms will return eventually.

What are the potential complications of ulcerative colitis?

Ulcerative colitis can lead to complications over time, such as anemia or bone problems. Some children with ulcerative colitis may have problems with growth and development. They may gain less weight than children without ulcerative colitis, or they may experience delayed puberty.

Long-standing ulcerative colitis that involves a third or more of the colon can increase the risk of colorectal cancer. This doesn’t mean you will get colorectal cancer if you have ulcerative colitis. It just means you should stay on top of screenings, such as colonoscopies, to find precancerous tissue. The earlier your doctor detects cancer, the easier it will be to treat.

What are the treatment options for ulcerative colitis?

Although there isn’t a cure for ulcerative colitis yet, treatment options are available. Medication can suppress inflammation and let colon tissue heal. Medication can also help control symptoms like diarrhea, abdominal pain, and bleeding. Over time, medication can reduce the frequency of flare-ups and increase remission times.

You can also manage ulcerative colitis with diet changes. Your food doesn’t cause ulcerative colitis, but certain foods can worsen the symptoms. Spicy foods, for example, can cause discomfort. High-fiber foods can also increase bowel movements, which can be uncomfortable for people with ulcerative colitis.

Surgery is often a last resort for ulcerative colitis. Your doctor may recommend it if you have stopped responding to medication. However, some people might choose surgery to improve their quality of life. If you are unsure which treatment option is best for you, talk to your doctor.

It’s important not to ignore the symptoms of ulcerative colitis. Although it cannot be cured, symptom management can improve your quality of life. You may go through flares and remissions, but you can control your ulcerative colitis by working closely with your doctor and staying informed about the condition.