Could You Have Ulcerative Colitis?

by Claire Gillespie Health Writer

Diarrhea and cramping are no fun for anyone. But if you’ve got ulcerative colitis (UC), a form of inflammatory bowel disease, these digestive issues can be so severe, they take over your life. In fact, your life may feel confined to bathroom.

That’s because UC causes chronic inflammation in the lining of the colon and rectum (told you it was no fun). The condition is most likely due to a faulty immune response (though genetics and the environment may also play a part), and it tends to develop gradually, according to the Mayo Clinic in Rochester, MN. Wondering if your belly issues could be UC? Check out the most common symptoms and see how they stack up against yours. If you've got some overlap, it's time to check in with your doctor.

Woman's feet shown in toilet stall as she goes to the bathroom with ulcerative colitis symptoms.
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You're on the Toilet…A Lot

Diarrhea—loose, watery stools three or more times in one day—is the most common symptom in UC, says Kevin Dholaria, M.D., a gastroenterologist with PIH Health Physicians in Whittier, CA. Many people experience a stint of diarrhea at some point in their life, but it lasts for only one or two days. The chronic diarrhea associated with UC is on a whole other level. It may feel never-ending, occurring multiple times a day for several days, and then it may disappear as the condition goes into remission.

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There's Blood in Your Poop

If you see red in the toilet, the blood may be due to flaring ulcers and/or small abscesses in the colon, both common symptoms of UC. It’s important to differentiate between UC bleeding and hemorrhoidal bleeding, which is caused by ruptured vein in the anus (you’ll often see blood on the toilet paper when you wipe). If you have diarrhea with blood or mucus, make an appointment with your doctor to get it checked out.

Woman hunches over on bed with stomach pain from ulcerative colitis.
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You Get Super Painful Cramps

“Someone having a UC flare will usually experience pain in the abdomen as well as the rectal area,” says Dr. Dholaria. These pains—caused by ulcers on the lining of the colon—can be very severe (at least an eight on a pain scale from one to 10), and often strike before passing a stool, according to Crohn’s & Colitis UK. As if this isn’t tough enough, gas pain and bloating can make the feeling worse.

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You Have to Go Right Now!

If the need to pass a stool frequently comes with little or no warning, you might have UC. This can be one of the most challenging and debilitating aspects of the condition, as it really affects quality of life. According to the Mayo Clinic, some people with UC are unable to have a bowel movement despite a feeling of urgency. This situation, called tenesmus, can happen when scar tissue builds up in the colon and rectum, making bowel movements more difficult.

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You Have a Fever

If you’re feeling feverish (remember, that’s a temp above 100.4°F/38°C) or having night sweats, UC might be the cause. Just like when your immune system flies into action to fight a virus or bacteria, often raising your temperature to do it, UC flares can trigger the same response as your body tries to deal with all that inflammation. Typically, you don’t need to call your doctor about a fever unless your temperature is 103°F or higher, or if you’ve had a fever for more than three days. But if your fever is connected to UC, you’ll likely have other symptoms, too.

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You're Never Hungry

If you have UC, you might not feel like eating much—that’s understandable, if you’re experiencing diarrhea, cramping and/or bowel urgency. “People with ulcerative colitis often have a reduced appetite as a result of nausea, abdominal pain or altered taste sensation,” notes the Crohn’s & Colitis Foundation. “This can make it difficult to consume enough calories and obtain sufficient nutrients.” If weight loss is an issue for you with UC, or you’re experiencing fatigue or low energy levels, speak to your doctor to ensure you’re getting all the essential nutrients.

You Feel Like You Could Sleep for a Week Straight

Extreme tiredness with UC can result from a number of issues—and it can be physical and/or mental exhaustion. If you’re struggling to get good quality sleep due to frequent bowel movements, it’s natural to feel run down during the day. Nutritional deficiencies, emotional stress, persistent pain and inflammation in the body might also cause fatigue. According to Crohn’s & Colitis UK, more than three-quarters of people experience fatigue during an IBD flare.

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You Can't Seem to Get Enough Water in You

If you suffer from frequent diarrhea with UC or aren’t drinking enough water because the condition makes you feel nauseous, dehydration can become a problem. One of the first signs is thirst (of course); others include a dry mouth, headache, lack of energy, and feeling faint when you stand up. Try to keep a water bottle handy and sip on the regular. Ice pops can also help if drinking feels like more than your belly can handle.

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Your Blood Tests Say You're Anemic

Anemia—when your blood has a shortage of healthy red blood cells, or hemoglobin—is a common complication of IBD and affects 21 percent of people with UC, according to a study published in Frontiers in Medicine. Ongoing inflammation and blood loss are likely to be the causes of anemia for IBD patients. “Iron deficiency may already impact the quality of life without anemia,” say the study authors. Severe iron-deficiency anemia is characterized by fatigue or tiredness, shortness of breath, or chest pain.

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You're Got Some Wacky Things Going on With Your Skin and Joints

“Some patients will also have other organ systems affected at the time they are diagnosed with UC,” says Dr. Dholaria. “Symptoms may include joint pain or inflammation, eye dryness, or skin complaints like burning, redness, or a rash.” One skin problem, called pyoderma vegetans, causes blisters, plaques, or patches around the groin and under the arms; as they heal, it darkens the affected skin. According to Crohn’s & Colitis UK, more than a third of people with UC develop other conditions outside of the digestive system.

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The Good News

If it turns out that you do have UC, you’ll be able to work with your gastroenterologist to develop a treatment plan that works for you, says Dr. Dholaria. Depending on the severity of your symptoms and level of inflammation, that might include medication, switching up your diet (keeping a food diary can help you pinpoint trigger foods), even figuring out new ways to stay on top stress. Sometimes more serious cases do require surgery. But with the right plan in place, it’s possible to induce remission. And that means you can get out of the bathroom and back to your life.

Claire Gillespie
Meet Our Writer
Claire Gillespie

Claire Gillespie writes about mental health, psoriasis, psoriatic arthritis and IBS for HealthCentral. She is a passionate about mental health awareness, and also writes about health and wellness for other sites, including Vice, SELF, Zocdoc, Reader’s Digest, and Healthline. You can follow her on Twitter @southpawclaire.