Ulcerative colitis

Symptoms of ulcerative colitis

The colon is the large intestine (bowel).

The rectum is the end of the bowel where stools (poo) are stored.

Small ulcers can develop on the colon's lining and can bleed and produce pus.

The main symptoms of ulcerative colitis are:

• recurring diarrhoea, which may contain blood, mucus or pus
• abdominal (tummy) pain
• needing to empty your bowels often

You may also experience:

• fatigue (extreme tiredness)
•  loss of appetite
• weight loss

The severity of the symptoms varies. This will depend on how much of the rectum and colon is inflamed and how severe the inflammation is.

Symptoms of a flare-up

Some people may go for weeks or months with very mild symptoms, or none at all (known as remission).

This can be followed by periods where the symptoms can be troublesome (known as flare-ups or relapses).

During a flare-up, some people with ulcerative colitis also experience symptoms elsewhere in their body. For example, some people develop:

• painful and swollen joints (arthritis)
• mouth ulcers
• areas of painful, red and swollen skin
• irritated and red eyes

In severe cases, for example, having to empty your bowels six or more times a day, additional symptoms may include:

• shortness of breath
• a fast or irregular heartbeat
• a high temperature (fever)
• blood in your stools becoming more obvious

In most people, no specific trigger for flare-ups is identified, although a gut infection can occasionally be the cause.

Stress is also thought to be a potential cause.

When to seek medical advice

You should see your GP as soon as possible if you haven't been diagnosed with the condition and you have the symptoms of ulcerative colitis.

They can arrange blood or stool (poo) sample tests. This is to help find out what may be causing your symptoms. If necessary, they can refer you to hospital for further tests.

If you've been diagnosed with the condition and think you may be having a severe flare-up, contact your GP or care team for advice. You may need to be admitted to hospital.

If you can't contact your GP or care team, contact GP out of hours service.

Causes of ulcerative colitis

Ulcerative colitis is thought to be an autoimmune condition. This means the immune system – the body's defence against infection – goes wrong and attacks healthy tissue.

Exactly what causes the immune system to behave in this way is unclear. Most experts think it's a combination of genetic and environmental factors.

Treating ulcerative colitis

Treatment for ulcerative colitis aims to relieve symptoms during a flare-up and prevent symptoms from returning.

Medication is usually used to help relieve symptoms. Your GP will discuss treatment options with you.

Mild to moderate flare-ups can usually be treated at home.

More severe flare-ups need to be treated in hospital to reduce the risk of serious complications.

If medications aren't effective at controlling your symptoms, or your quality of life is significantly affected by your condition, surgery to remove your colon may be an option.

The difference between IBD and IBS

Inflammatory bowel disease (IBD) is a term mainly used to describe two conditions that cause inflammation of the gut (gastrointestinal tract). They are:

• ulcerative colitis
• Crohn's disease

IBD shouldn't be confused with irritable bowel syndrome (IBS), which is a different condition and requires different treatment.

More useful links

• How to use your health services
• Inflammatory bowel disease self-management leaflet