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Ulcerative Colitis

What Are The Symptoms Of Ulcerative Colitis?

Monday, March 4, 2013 - 09:44

Contributing Author: Guy Slowik FRCS

The immediate symptoms of ulcerative colitis may be the same as those found in a number of other conditions that affect the bowel, such as viral, bacterial, or parasitic infection. A complete medical history and a thorough physical examination, along with laboratory and diagnostic tests, are necessary to diagnose ulcerative colitis.

Symptoms vary. They may be mild or very severe. They may come on suddenly or develop gradually. In some people the severity of the symptoms may vary with the season--worse in winter and less in summer.

Three classic symptoms indicate the possibility of inflammatory bowel disease. These symptoms only occur during flare-ups, when the disease is active. However, radiological and laboratory tests continue to show signs of the disease even during times of clinical remission.

The three classic symptoms of ulcerative colitis are:

Other symptoms may include fatigue, weight loss and loss of appetite.

In addition, there may be other signs and symptoms not related to the colon that could indicate ulcerative colitis.


Three or more watery stools per day is considered diarrhea.

In cases of ulcerative colitis, frequent watery stools are the norm. Many times, these stools are accompanied by thick blood (not bright red smears of blood, which usually occur from a bleeding hemorrhoid). Mucus or pus also often passes with the stool. Occasionally, an individual with ulcerative colitis will have stool of more normal consistency that contains pus or mucus.

Abdominal Pain

Pain from ulcerative colitis is often crampy in nature and felt on the left side of the abdomen. This is logical, since the rectum above the anus moves to the left side, where it connects to the rest of the colon. Often in ulcerative colitis, the pain and cramps subside immediately after a bowel movement.


Ulcerative colitis is an inflammatory disease, and one of the key characteristics of the inflammatory process is fever (the others being pain, heat, and redness). Some individuals with ulcerative colitis suffer a high fever, especially during the acute phase of a flare-up. Others run a persistent, low-grade fever.

This fever may be accompanied by irritability and fatigue. Sometimes, the fever comes back each day, especially later in the day, then repeatedly breaks during sleep, causing night sweats.

Signs And Symptoms Not Related To The Colon

There are a number of possible signs and symptoms of ulcerative colitis that can occur outside the colon. Sometimes these occur at the same time as the intestinal symptoms, but other times they occur weeks or even months before any intestinal symptoms occur. If a doctor suspects inflammatory bowel disease, he or she will ask detailed questions about whether certain symptoms have appeared.

It is not known why symptoms occur outside the colon, but it is likely due to the immune system causing inflammation in other parts of the body.

Among these are:

  • Reddening and inflammation of the eye (iritis)
  • Joint pains, usually in the large joints of the knees, ankles, elbows, wrists, and shoulders, which sometimes migrate from one joint to another (migrating arthralgia)
  • Skin lesions including tender red nodules on the shins or calves (erythma nodosum)
  • Sores inside the mouth (aphthous ulcers)

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