10 Can’t-Miss Ulcerative Colitis (UC) Symptoms

Ulcerative colitis is a painful and potentially dangerous condition that affects approximately 750,000 people in the United States every single year. While it can affect people of any age, the majority of patients are first diagnosed between 15-30 years old.

How Does Ulcerative Colitis (UC) Happen?

This condition is part of the inflammatory bowel disease family, or IBD. Particularly, ulcerative colitis refers to the inflammation of the lining of your large intestine.

This inflammation causes the contents of your colon to empty rapidly and frequently. This rapid movement through the intestine kills the cells on the surface of the bowel lining. This process, in turn, leads to the formation of ulcers.

What are the Complications of this Condition?

While ulcerative colitis can be painful enough to deal with alone, there are some serious complications that can occur as well. The first and major concern is colon cancer caused by the dead cells on the lining of your colon.

Other complications may include:

  • Thickening of the intestinal wall
  • Sepsis
  • Dangerous dehydration
  • Toxic megacolon
  • Intestinal bleeding
  • Kidney stones
  • Inflammation of your skin, joints, and eyes
  • Rupture of your colon
  • Ankylosing spondylitis

What are the Symptoms of Ulcerative Colitis?

Clearly, it’s important to deal with this serious condition right away. In order to deal with it, though, you first have to recognize that there’s a problem in the first place.

So what are the signs you may have ulcerative colitis?…

1. Diarrhea

Diarrhea is something that can be caused by a number of conditions, including stress and various infections. However, there are some key markers you want to watch for as indicators of ulcerative colitis.

What Makes Diarrhea Different with Ulcerative Colitis?

Unlike diarrhea that comes with viral and bacterial infections, ulcerative colitis diarrhea may also have blood, mucus, or pus in it.

Why Does Ulcerative Colitis Cause Extra-Gross Diarrhea?

The Short Answer

Intestinal inflammation will cause diarrhea. So, any IBD may be accompanied by diarrhea. As for the blood, mucus, and pus that is in the stool? They are by-product wastes of the ulcers themselves.

The Long Answer

With ulcerative colitis, cells die in the intestinal lining. So, the gut will attempt to heal itself as these cells die. One by-product of the body’s immune response? Pus, which is basically filled with infected tissues, white blood cells, bacteria, serum, and tissue debris. This pus may then find its way into your stool.

Okay, but what about the bleeding? Well, as the ulcers get worse or are irritated by frequent loose stools, they tend to bleed; this blood often finds its way into stools. This response is normal, although it can be concerning when it happens inside the body.

When to Seek Medical Attention

If you experience any blood in your stool or you have diarrhea for more than 3 days, you should seek medical attention. If your stool is a dark, tar-like substance, you should seek immediate medical care as this sign could indicate significant internal bleeding.

The following sign of UC also often flies under many people’s radars as it can be the result of any number of conditions…

2. Abdominal Pain & Cramping

Just like diarrhea, there are many possible causes of abdominal pain and cramping. However, those who have been diagnosed with ulcerative colitis (or suspect that they have this condition) should pay close attention to this discomfort.

How Does Ulcerative Colitis Cause Abdominal Pain?

Ulcerative colitis causes pain in a couple of ways.

  • Ulcers. Ulcers are holes in the intestinal lining. Naturally, these ulcers are quite painful. As they grow, the pain associated with them also intensifies.
  • Intestinal Inflammation. Inflammation in any bodily tissue will cause pain. Now, the intensity of the inflammation affects your level of discomfort, especially the cramping. Certain food, situations, and events can trigger increased inflammation.

What are Some Common Triggers?

These triggers include:

  • Beans
  • Bran
  • Fatty meat
  • Brown rice
  • Dairy
  • Fruit
  • Popcorn
  • Certain vegetables
  • Seeds
  • Stress
  • Infections
  • Antibiotics
  • NSAIDs

Why is Abdominal Pain with Ulcerative Colitis Important?

Abdominal pain and cramping are common symptoms of ulcerative colitis. An increase in pain can be a sign of a flare-up or that your ulcerative colitis is getting worse.

When To Seek Medical Attention

You should seek medical attention if your pain is debilitating or if the medications you have been prescribed are not effective in reducing your pain.

You should also seek immediate medical care if your pain is focused on the lower right of your abdomen, as that may be a sign of a medical emergency that is not related to your ulcerative colitis.

While cramping and pain is common, the following sign of UC can appear downright alarming…

3. Rectal Bleeding

Rectal bleeding is a sign of a possible medical emergency; it may also be related to ulcerative colitis or even hemorrhoids. Whatever the cause, it’s always important to take this symptom seriously.

Why Does Ulcerative Colitis Cause Rectal Bleeding?

There are two primary reasons why ulcerative colitis may cause rectal bleeding.

  • Ulcers. As ulcers develop and worsen, they may bleed, resulting in mucus or pus.
  • Rectal Irritation. When passing frequent diarrhea, the rectum may become irritated, which can lead to superficial bleeding.

When is Rectal Bleeding Important?

The severity of the rectal bleeding may give you a clue as to how severe your ulcerative colitis is. For example, if there is just a little superficial blood on the surface of your stool, keep an eye on it. However, this surface-level blood typically is not something to be overly concerned about.

On the other hand, rectal bleeding may be unrelated to a bowel movement and can range from severe or minor. If it seems concerning to you or lasts for several days, be sure to see your doctor.

When To Seek Medical Attention

Some rectal bleeding is cause for concern and should be evaluated immediately. If you have black tarry-looking stools or have a large amount of blood either with or without a bowel movement, you should seek immediate medical attention. These symptoms can be a sign of worsening ulcers with significant internal bleeding.

While some people may experience diarrhea and rectal bleeding, other people with this condition may experience the complete opposite problem…

4. Inability to Pass Stool

Constipation is another symptom of ulcerative colitis, though it is less frequently reported than diarrhea.

Why Does Ulcerative Colitis Cause Constipation?

The initial cause of ulcerative colitis-related constipation? Inflammation of the rectum (ulcerative proctitis). Specifically, when the rectum becomes inflamed, it can restrict the ability of the rectum to expand (aka, allowing stool to pass). It may also inhibit the normal muscular movement of the rectum, which is what helps move stool out.

The other complication of ulcerative colitis that can lead to constipation? Colon cancer. Namely, people with ulcerative colitis are at increased risk for colon cancer. As cancer grows in the colon, it will restrict the waste’s ability to pass through the intestine and rectum. When this happens, it often means surgery is necessary to resection the colon. This process can remove the cancer and ensure clear passage.

When to Seek Medical Attention

Constipation is occasionally a normal part of everyone’s life, with or without ulcerative colitis. However, when you have less than three bowel movements in a week or go for more than three days without a bowel movement, it is time to seek assistance.

Be Wary of Over-the-Counter Remedies

If you have ulcerative colitis—or if you think you may have it—be wary of common treatments for constipation. Why? Because remedies like laxatives, bran, and other stool softeners can exacerbate or cause a colitis flare-up. Be sure to speak with your physician on how to properly treat and prevent constipation if you have ulcerative colitis.

The following sign of UC might initially seem welcome, but don’t be fooled; it can result in some serious complications…

5. Weight Loss

Most people would not mind losing a few pounds. However, unintentional weight loss, especially combined with other symptoms, may be a sign of ulcerative colitis.

Why Does Ulcerative Colitis Cause Weight Loss?

Weight loss can be an unfortunate side effect of ulcerative colitis. Why does it happen, though? The truth is, it can be caused by any number of other UC symptoms.

  • Loss of Appetite. Firstly, the pain and discomfort that accompany this condition can make people lose their appetites.
  • Diarrhea. Secondly, diarrhea associated with the condition can lead to rapid weight loss. This loss is partly due to the dehydration that accompanies diarrhea.
  • Malnutrition. Your intestinal tract is what absorbs nutrients from the food you eat. Naturally, when that tract is inflamed and full of holes, it cannot absorb those nutrients. Rather than going to work in your body, they instead get flushed out in diarrhea. This particular cause of weight loss is of significant concern for patients with ulcerative colitis, as malnutrition can lead to many other issues in the body.

When is Weight Loss a Concern?

Any time you have significant weight loss—usually defined by losing at least five percent of your weight in less than 6-12 months—is time to see your doctor.

If your weight loss is due to malnutrition caused by ulcerative colitis, it is important to develop a management plan to allow your body to start receiving proper nutrients again.

The following UC sign is also not as common, although it too can result in plenty of complications…

6. Fever

In some cases, ulcerative colitis may be accompanied by a fever, though it is usually not a long-lasting one.

Why Does Ulcerative Colitis Cause Fever?

While fevers are not generally associated with ulcerative colitis, they can still be signs of a flare-up. Fevers can be caused by a number of issues related to this IBD.

  • Inflammation. Firstly, mild fevers can simply be a result of the inflammation. Namely, inflammation is a common immune system response to a flare-up. So, a mild fever may be an indicator that a flare-up is starting.
  • Complications. Fevers can also indicate more significant side effects like toxic megacolon. This particular complication can be life-threatening and should be treated immediately.

Is a Fever Something to Be Concerned About?

Be sure to talk with your doctor about proper fever management as some fever reducers can be triggers for an ulcerative colitis flare-up.

If your fever lasts more than a couple of days or is higher than 103° F, you should consult with your doctor to ensure there are no other significant complications.

When To Seek Medical Attention

If you have

  • a long-lasting fever,
  • one that does not respond to fever-reducing medication,
  • is accompanied by other significant symptoms,

you should seek immediate medical attention.

Of course, UC doesn’t just affect your GI tract; it can lead to plenty of other symptoms in other areas of the body…

7. Joint Pain

Joint pain is something many people deal with, especially as they age or deal with conditions like arthritis. Many are surprised to hear that joint pain is the leading non-GI related symptom of ulcerative colitis, affecting roughly thirty-percent of UC patients.

Why Does Ulcerative Colitis Cause Joint Pain?

Research suggests that the gene that leads to ulcerative colitis also makes people more susceptible to arthritis, including at a younger age. Specifically, ulcerative colitis-related inflammation of the intestinal tract triggers a pain response in the joints; this response mirrors arthritic pain.

How is Joint Pain with Ulcerative Colitis Different than Arthritis?

There are two primary differences between the joint pain associated with ulcerative colitis and regular arthritis.

  • Firstly, UC pain usually dissipates as the intestinal swelling decreases. This fact also means you may experience more pain during flare-ups.
  • Secondly, unlike arthritis, this condition does not usually cause lasting damage to the joints.

When To Seek Medical Attention

You may want to talk with your doctor about how to manage these symptoms when you first experience them. Your doctor will check that you are not developing regular arthritis and will be able to recommend treatment that will not further exacerbate your UC.

Unfortunately, joints aren’t the only non-GI tract symptoms that UC can cause…

8. Skin Sores & Rashes

Ulcerative colitis prevents the gut from doing its job correctly, which has long-ranging consequences across your body. These consequences include problems with your skin.

Why Does Ulcerative Colitis Cause Skin Sores and Rashes?

Inflammatory Issues

Ulcerative colitis is an inflammatory condition. As such, part of what it does is increase c-reactive proteins in the blood. Unfortunately, this process affects more than just the tissues in the gut. Rather, these proteins circulate throughout the entire body. The result? They can trigger additional inflammatory responses elsewhere, including the skin.

Connection to Genetic Conditions

Additionally, ulcerative colitis is thought to be linked to some genetic conditions as well as some immune system problems. As such, some of these skin conditions may be linked to these issues rather than just the inflammation itself.

What Kind of Skin Problems Does UC Cause?

Some of the skin conditions associated with ulcerative colitis flare-ups include:

  • Erythema nodosum
  • Pyoderma gangrenosum
  • Psoriasis
  • Hives
  • Acne
  • Bowel-associated dermatosis-arthritis syndrome
  • Pyodermatitis-pyostomatitis vegetans
  • Sweet’s syndrome
  • Vitiligo
  • Leukocytoclastic vasculitis

When To Seek Medical Attention

See your doctor if your symptoms do not resolve when your flare-up subsides or if the skin condition causes open wounds. After all, these open wounds can lead to infection. Left untreated, some of these infections may be life-threatening.

If the symptoms do not subside with the intestinal inflammation, it indicates a connection to a genetic connection or some other immune dysfunction.

Rashes may be easy to spot. Unfortunately, the following sign of UC can be much trickier to diagnose…

9. Anemia

There are several varieties of anemia with a host of different causes. With ulcerative colitis, the most common variety is iron-deficiency anemia.

What is Anemia?

Anemia means the body lacks enough healthy red blood cells, which importantly help perform functions like transport oxygen across the body. Without proper oxygen, tissues start to die.

What is Iron-Deficiency Anemia?

Iron-deficiency anemia is anemia that develops due to an iron deficiency.

Why Does Ulcerative Colitis Cause Anemia?

Ulcerative colitis can cause anemia in patients in three primary ways.

  1. Inflammation and Diarrhea. These side effects of UC mean that the bowels are not able to properly absorb enough iron, which leads to anemia.
  2. Not Eating Enough Iron-Rich Foods. Some people avoid these foods because they trigger flare-ups. Unfortunately, that also means anemia can develop as they do not get enough dietary iron to promote healthy red blood cell production.
  3. Bleeding from Ulcers during Flare-Ups. Blood is rich in iron. So, losing blood means losing iron. Therefore, bleeding ulcers can lead to an iron deficiency, which in turn may result in anemia. Notably, when this sort of blood loss occurs, it is usually quite severe, meaning it requires immediate medical attention.

What is the Problem with UC-Caused Anemia?

With ulcerative colitis, anemia can become a perpetual issue. Specifically, the consistent lack of oxygen can cause further damage to the intestinal tract. This damage can lead to the anemia worsening as iron won’t be properly absorbed. In short, it can create a self-perpetuating cycle.

When To Seek Medical Attention

If you think you may be suffering from anemia—either caused by ulcerative colitis or some other condition—it is important to seek advice from your doctor. Treatments can be simple, including supplements and simple diet changes. However, the consequences can be severe if left untreated.

Other times, the side effects of anemia (and, by extension, UC) can be relatively mild, although they can still negatively impact your day-to-day life…

10. Fatigue

Many patients who suffer from ulcerative colitis also report having unusual fatigue. This fact is especially true during flare-ups.

Why Does Ulcerative Colitis Cause Fatigue?

Many of the complications of ulcerative colitis will also cause the body to feel tired and lethargic.

  • Diarrhea can cause fatigue from dehydration.
  • Malnutrition can cause fatigue because the body does not have the nutrients it needs to effectively fuel its tissues and processes.
  • Anemia can contribute to the feeling of fatigue.
  • Prolonged pain, either from abdominal cramping or UC-related arthritis, can cause fatigue.

What Does Fatigue Tell Us?

Fatigue is one way your body tells you that something is wrong. So, if you see an increase in the level of fatigue you experience during flare-ups, you should seek medical advice. It can be an early indicator of some of the more severe side effects of ulcerative colitis. Therefore, early treatment can improve your outcomes.

What’s Next?

What is most important for someone who thinks they may have UC to know?…

Know The Signs, Seek Help

Ulcerative colitis can lead to devastating consequences like cancer; that’s why it’s important to seek professional treatment for this condition right away. However, in order to receive treatment, you first have to identify a problem in the first place. That is why it’s important to know the symptoms of this condition.

Develop a Strong Management Plan

Unfortunately, UC cannot be cured, only managed long term. However, a good doctor will help you craft an effective management plan to keep your flare-ups to a minimum. This plan may include medications, supplements, and changes to diet.

Furthermore, to keep the risk of significant complications down, you need to follow the management plan closely.

Know When to Seek Immediate Help

Know the warning signs that would indicate you need to seek immediate help. While your doctor will give you a full list personalized for you, generally you should seek immediate help if you:

  • Have black, tar-like stool
  • Show signs of severe dehydration (increased thirst, sleepiness, dry skin, dizziness, dry mouth, etc.)
  • Have abdominal tenderness
  • Experience severe abdominal pain localized to the right side of your abdomen
  • Have a visibly distended or bloated abdomen
  • Have a sudden decrease in the number of bowel movements
  • Have a high fever (103° F or above)

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