The Most Common Ulcerative Colitis Symptoms

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Diarrhea and cramping: no fun for anyone. But if you’ve got ulcerative colitis (UC), these digestive issues can be so severe, they can dictate how you live your life. Suspect you might have UC? We’ve rounded up the most common symptoms and warning signs — and steps you can take to get some relief.


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What is ulcerative colitis, anyway?

UC is one of several conditions considered an inflammatory bowel disease (IBD) — Crohn’s disease and microscopic colitis are others. These conditions involve chronic inflammation of the gastrointestinal (GI) tract, according to the Centers for Disease Control and Prevention (CDC). UC occurs in the colon (large intestine) and the rectum, with inflammation in the innermost layer of the colon lining. “IBD is the result of a defective immune system,” the CDC says. Genetics and environment are other factors.


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Persistent diarrhea: The most common UC symptom

The most common UC symptom is diarrhea. Diarrhea occurs when you experience loose, watery stools three or more times in one day. Many people have acute diarrhea, lasting one or two days, at least once in their life. But the chronic diarrhea associated with UC is different — it’s persistent, occurs multiple times in one day, can last for days, and then may disappear as the condition goes into remission.


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Cramping and abdominal pain impact half of UC patients

Abdominal pain and cramping are common in UC and affect more than 50 percent of UC patients. Inflammation is a key component in these symptoms, but not the only one, according to researchers: They found a correlation between chronic UC pain and coexisting mood disorders as well. “Management strategies should thus go beyond a focus on inflammation and also include interventions that target psychological mechanisms of pain,” they reported.


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Watch for bloody stool

Seeing red in the toilet can be scary. If you have bloody diarrhea, sometimes containing pus or mucus, it may be a symptom of UC. The blood in stools in UC is caused by ulcers and small abscesses in the colon and rectum flaring.


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Urgency to go: Another common UC symptom

Do you ever feel the need to go, like right now? Some people report feeling that they have little warning before they need to have a bowel movement, making it difficult to get to a bathroom in time. This symptom is common with UC.


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Don’t forget gas, bloating

Some people with UC report gas and bloating. Bloating can be a common symptom of irritable bowel syndrome (IBS) as well, which you’re at greater risk of having with UC. Avoiding foods that cause issues and following a low-FODMAP diet might help.


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Fever can accompany UC

Feeling feverish, or waking up in a sweat? Fever and night sweats can be common symptoms of UC. If you're temperature is above 99°F to 99.5°F (37.2°C to 37.5°C), it's considered a fever. Keep in mind that other factors can impact this, resulting in higher temperatures but no fever. Those include time of day, women’s menstrual cycles, physical activity, strong emotion, eating, heavy clothing, medicines, high room temperature, and high humidity.


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Sleep interruption can be debilitating with UC

During a UC flare, some people awake often throughout the night due to frequent bowel movements. Sleep interruption can become a serious problem if you have UC.


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Fatigue in UC has many possible causes

Tiredness, from a variety of reasons, can impact you when you have UC. This fatigue can be physical, mental, or both. Fatigue with UC can be the result of inflammation, pain, nutritional deficiencies, emotional stress, medication, disturbed sleep, and other factors. And it’s common, too: According to Crohn’s & Colitis UK, more than three-quarters of people experience fatigue during an IBD flare.


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Nausea: A nasty UC symptom

Feel sick to your stomach? This could be a symptom of UC. Vomiting can also occur.


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Loss of appetite can occur with UC

Not hungry, no matter what you have available to eat? Loss of appetite can be a common symptom of UC, leading to weight loss. Eating when you can is important.


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Weight loss: A major UC symptom

UC hinders the body’s ability to absorb both nutrients and calories. As a result, if you have UC, you might also have nutrition deficiencies and struggle to keep weight on.


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Watch out for anemia with UC

Anemia is one of the most frequent complications of IBD, according to a study published in Frontiers in Medicine in 2015. The causes of anemia for IBD patients are likely disrupted absorption due to inflammation and continuous blood loss. “Iron deficiency may already impact the quality of life without anemia,” say the study authors. Symptoms of more severe iron-deficiency anemia are fatigue or tiredness, shortness of breath, or chest pain.


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Dehydration, a serious UC symptom

Many people experience dehydration during an UC flare. It is important to drink as much water as possible during a flare to avoid dehydration.


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Don’t overlook skin symptoms in UC

A host of skin conditions can impact you when you have UC. Canker sores, red bumps on your ankles, and small blisters that become lesions are just a few of the skin issues that UC can cause. One skin problem, called pyoderma vegetans, causes blisters, plaques, or patches around the groin and under the arms that darken the skin as they heal.


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Keep track of your UC symptoms

Everyone will experience UC in a different way and on a different schedule. Tracking the frequency and severity of each of your symptoms can help minimize both the number and severity of UC flares. Keep a symptom journal to take with you to your doctor visits.


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See a health professional about UC symptoms

Do any of these symptoms sound familiar? Then it’s time to see a gastroenterologist. They will order the necessary tests to determine how best to treat your symptoms. Many of these symptoms are serious, and some — heavy, persistent diarrhea, rectal bleeding with clots of blood, constant pain, and high fever — require immediate medical attention. See a health professional about your symptoms as soon as possible.