Symptoms

The two major inflammatory bowel diseases, ulcerative colitis and Crohn's disease, share certain characteristics:

• Symptoms usually appear in young adults.
• Symptoms can develop gradually or have a sudden onset.
• Both are chronic. In either disease, symptoms may flare up (relapse) after symptom-free periods (remission) or symptoms may be continuous without treatment.
• Symptoms can be mild or very severe and disabling.

The symptoms of ulcerative colitis depend in part on how widespread the disease is and the severity of the inflammation. Common symptoms include:

• Diarrhea
• Rectal bleeding and bloody stool
• Difficulty or pain when passing stool
• Abdominal cramps

Other Symptoms

Eyes. Inflammation in the pigmented part of the eye, a condition called uveitis, is a common complication.

Joints. There is a fairly strong association with seronegative spondyloarthropathies (psoriatic arthritis, ankylosing spondylities, and other disorders). These forms of arthritis involve joints of the limbs and the spine.

Skin Disorders. Patients with ulcerative colitis have a higher risk for skin disorders and may experience an ulcerative rash called pyoderma gangrenosum that tends to heal in the center but continue to spread. Patients may also have mouth sores.

Other symptoms may include:

• Fever
• Nausea
• Loss of appetite and weight loss
• Fatigue

Prognosis. About half of patients with ulcerative colitis have mild symptoms while another half go on to develop more severe forms of the disease. Patients with more severe ulcerative colitis tend to respond less well to medications.

The course of ulcerative colitis is unpredictable. Some patients go into remission after a single attack, while others develop a chronic condition. There is no cure for ulcerative colitis (aside from surgical removal of the colon), but medications can help suppress the inflammatory response and control symptoms. About two-thirds of patients achieve remission when treated with medications, and about 80% are able to maintain remission.

Review Date: 09/28/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)