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Symptoms
By Mayo Clinic staff
Ulcerative colitis symptoms can vary, depending on the severity of inflammation and where it occurs. For these reasons, doctors often classify ulcerative colitis according to its location.
Here are the signs and symptoms that may accompany ulcerative colitis, depending on its classification:
- Ulcerative proctitis. In this form of ulcerative colitis, inflammation is confined to the rectum and for some people, rectal bleeding may be the only sign of the disease. Others may have rectal pain, a feeling of urgency or an inability to move the bowels in spite of the urge to do so (tenesmus). This form of ulcerative colitis tends to be the mildest.
- Proctosigmoiditis. This form involves the rectum and the lower end of the colon, known as the sigmoid colon. Bloody diarrhea, abdominal cramps and pain and tenesmus are common problems associated with this form of the disease.
- Left-sided colitis. As the name suggests, inflammation extends from the rectum up the left side through the sigmoid and descending colon. Signs and symptoms include bloody diarrhea, abdominal cramping and pain on the left side, and unintended weight loss.
- Pancolitis. Affecting the entire colon, pancolitis causes bouts of bloody diarrhea that may be severe, abdominal cramps and pain, fatigue, and significant weight loss.
- Fulminant colitis. This rare, life-threatening form of colitis affects the entire colon and causes severe pain, profuse diarrhea and, sometimes, dehydration and shock. People with fulminant colitis are at risk of serious complications, including colon rupture and toxic megacolon, which occurs when the colon becomes severely distended.
The course of ulcerative colitis varies, with periods of acute illness often alternating with periods of remission. But over time, the severity of the disease usually remains the same. Most people with a milder condition, such as ulcerative proctitis, won't go on to develop more-severe signs and symptoms.
When to see a doctor
See your doctor if you experience a persistent change in your bowel habits or if you have any of the signs and symptoms of ulcerative colitis, such as:
- Abdominal pain
- Blood in your stool
- Ongoing bouts of diarrhea that don't respond to over-the-counter (OTC) medications
- An unexplained fever lasting more than a day or two
Although ulcerative colitis usually isn't fatal, it's a serious disease that, in some cases, may cause life-threatening complications.
- About ulcerative colitis and proctitis. The Crohn's and Colitis Foundation of America. http://www.ccfa.org/info/about/ucp. Accessed June 30, 2009.
- Ulcerative colitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec02/ch018/ch018c.html. Accessed June 30, 2009.
- Peppercorn MA, et al. Medical management of ulcerative colitis. http://www.uptodate.com/home/index.html. Accessed June 30, 2009.
- Ulcerative colitis. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/colitis/. Accessed June 30, 2009.
- Accutane (prescribing information). Nutley, N.J.: Roche; 2008. http://www.rocheusa.com/products/accutane/pi.pdf. Accessed June 23, 2009.
- Inflammatory bowel disease. In: Rakel RE, et al. Conn's Current Therapy 2008. 60th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/144932667-4/854785995/1621/261.html#4-u1.0-B978-1-4160-4435-2..50133-3--cesec17_2085. Accessed June 21, 2009.
- Rutgeerts P, et al. Biological therapies for inflammatory bowel diseases. Gastroenterology. 2009;136:1182.
- Enck P. Acupuncture treatment in gastrointestinal diseases: A systematic review. World Journal of Gastroenterology. 2007;13:3417.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. July 20, 2009.
