What is ulcerative colitis?

Ulcerative colitis (UC) is a long-term, chronic disease that causes inflammation of your bowel. It may affect as many as 907,000 people in the United States, reports the Crohn’s and Colitis Foundation of America. It can develop at any age, but it’s typically diagnosed in people in their mid-30s.

When you have UC, your body treats the lining of your colon as foreign, and attacks it. This causes painful ulcers and sores to develop. It can result in a variety of uncomfortable symptoms that negatively impact your life. The condition also increases your risk of colon cancer, so typically colonoscopies are needed on a regular basis.

UC can develop in various parts of your colon. The more of your colon that is affected, the more serious your symptoms will be. If you develop inflammation that only occurs near your anus, it’s known as ulcerative proctitis. Rectal bleeding may be the only sign of this type of colitis. Fulminant pancolitis is a more severe form of the disease that affects your entire colon. It can cause severe pain and uncontrollable diarrhea. In some cases, it can lead to blood stream infections and even death. This type of colitis is a medical emergency.

UC can cause a variety of symptoms. Weight loss is common. People with UC typically experience one or more of the following:

  • abdominal pain and cramping
  • diarrhea or constipation
  • bleeding or discharge from your rectum
  • anemia and fatigue
  • joint pain or clubbing of fingers

Cramps and abdominal pain

If you have UC, you may experience abdominal pain with cramping. It can range from mild to severe.

Anti-spasmodic medications might help relieve your pain. Heating pads and rest may also provide relief. Sometimes, your cramping may be severe enough that you need prescription medications to manage it.


Another common symptom of UC is diarrhea. In some cases, it may contain blood, pus, or mucus.

You may experience sudden urges to defecate that are difficult to control. Incontinence can happen as well. These urges may occur up to 10 times per day and sometimes at night. This may compel you to plan your days around your bathroom breaks. In some cases, it may even lead you to become homebound.

Medications may help you control diarrhea, but it’s important to talk to your doctor before taking any over-the-counter drugs. Some common anti-diarrheal medications may make your condition worse.

Constipation and tenesmus

It’s also possible to experience constipation as a result of UC but it’s significantly less common than diarrhea.

You might also experience tenesmus. This is a feeling of incomplete evacuation, or the need to have a bowel movement even when you’ve recently emptied your colon. It may cause you to strain and cramp up.

Stool bulking drugs, such as psyllium husk (Metamucil, Fiberall), may help control these symptoms.

Rectal bleeding and discharge

UC often causes bleeding or mucus discharge from your rectum. You may find spots of blood or mucus in your toilet or on your clothing. Your stool may also become very soft and bloody or contain red streaks or mucus. You may also experience pain in your rectal area, as well as a persistent feeling of needing to have a bowel movement.

Anemia and fatigue

If you experience frequent bleeding in your gastrointestinal tract, you may develop anemia. This complication of UC can result in fatigue. Even without anemia, fatigue is a common symptom among people with UC.

Anemia-related fatigue is different than just being tired. If you develop significant anemia, you won’t feel refreshed after resting. Your breathing may become labored. Even simple activities may seem challenging. Other potential symptoms of anemia include:

  • dizziness
  • headaches
  • pale skin

To diagnose anemia, your doctor will likely order a blood test. They may encourage you to take over-the-counter iron supplements or prescribe other treatments.

Joint pain and clubbing of fingers

If you have UC, you may develop aching joints that commonly involve your low back, hips and knees, but can affect other joints as well. UC can also affect your skin, eyes, liver and lungs. In some cases, clubbing of your fingers may occur. Potential symptoms of clubbing include:

  • downward curving of your nails
  • increased roundness and widening of your nails
  • increased angle between your nails and cuticles
  • bulging of the tips of your fingers
  • warmth or redness of the tips of your fingers

If you have UC, your symptoms typically come and go. For that reason, it’s called a relapsing-remitting disease. When your symptoms start up, you’re entering a “flare-up.” They can last anywhere from days to months. When your symptoms disappear, you’re entering remission.

In some cases, you may be able to identify and avoid triggers that cause flare-ups. Avoid known triggers. Follow your doctor’s prescribed treatment plan to limit flare-ups, to treat flare-ups and to keep your symptoms under control.

If you suspect you have UC, make an appointment with your doctor. They will ask you about your symptoms and medical history. They may order lab tests and CT scans, along with a colonoscopy.

If you’re diagnosed with UC, it’s important to follow your doctor’s recommended treatment plan. Often a combination of lifestyle changes, medications, and other treatments are recommended. A variety of medications have been shown to be beneficial in managing UC. However, over 25 percent of people may require surgery to manage it, according to the Crohn’s and Colitis Foundation of America. Ask your doctor for more information about your specific condition, treatment options, and long-term outlook. With successful management, it’s possible to lead a healthy and active lifestyle with UC.