11 Ulcerative Colitis Symptoms You Should Never Ignore

If you find yourself doubled over with diarrhea and cramps, your first move might be to check the expiration date on that milk you poured in your cereal. But if your digestive woes persist, or you also see blood in the toilet, it’s possible you could be experiencing something like ulcerative colitis symptoms instead of food poisoning. Ulcerative colitis (UC) is an autoimmune disease where your body’s immune system mistakenly attacks cells in the colon, or large intestine. Cue the stomach trouble. Let’s jump into the details of what to look for and what you can do.

What is ulcerative colitis, exactly?

Ulcerative colitis (UC) is one of the two main forms of inflammatory bowel disease (IBD). The other is Crohn’s disease. UC occurs when the immune system malfunctions, causing inflammation and ulcers (sores) to appear on the inner lining of the large intestine, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). It’s not comfortable, to put it mildly, and not something that will clear up quickly.

Ulcerative colitis is a chronic illness that does not yet have a medical cure. That doesn’t mean nothing can be done though, so don’t despair if you’re experiencing symptoms. Sidhartha Sinha, M.D., a gastroenterologist, assistant professor at Stanford Medicine, and researcher who specializes in IBD, tells SELF that while there aren’t medical cures for ulcerative colitis, there are medical treatments. “And we have made great advancements in these treatments,” he says. The last resort is a surgical option called colectomy—the removal of the entire colon—which can eliminate UC entirely.

What are the most common ulcerative colitis symptoms?

Early ulcerative colitis symptoms usually include things that could easily be overlooked. Don’t be afraid to talk to a doctor if you’re having any worries though, even if your symptoms seem mild. If symptoms are ongoing and start to feel more severe, like persistent pain in your abdomen or unintentional weight loss, you should seek medical treatment as soon as possible.

Here are some of the most common symptoms of ulcerative colitis to watch out for, per the NIDDK:

Bloody diarrhea

OK, so this isn’t the most pleasant one to start with, but it is actually the most common ulcerative colitis symptom—it’s also a pretty good tip-off that something isn’t quite right and that you should schedule an appointment with your doctor. Remember those ulcers we talked about earlier? Yeah, that’s where the blood in your stool comes from, and you might also see mucus in there as well.

Abdominal pain and cramping

This is another pretty common symptom, and contrary to popular belief, those ulcers in the colon are not actually what causes the pain. Instead, it’s a combination of abdominal cramping and bowel distension (stretching) that occurs due to the inflammation in the intestines, according to a 2013 study published in Inflammatory Bowel Diseases.1

Rectal pain

Pain in your rectum (the part of the colon right before your anus) is also another unpleasant symptom you may deal with. Ulcerative colitis often starts in this portion of your bowel, according to the Cleveland Clinic, so it’s no surprise that the inflammation and damage that occurs in that area can cause some uncomfortable feelings. If your symptoms only affect that area and don’t progress, it’s actually called ulcerative proctitis.

The urge to have a bowel movement

This could be a constant, phantom urge (you don’t really need to poop), or an actual urgent need to run to the bathroom. In terms of how many bowel movements are considered “normal,” it varies. You may have fewer than four bowel movements a day (this is considered mild symptoms), and others may have more than six bowel movements with blood most of the time (this is considered severe). In extremely severe cases, you might have 10 bloody bowel movements in a day.

Fatigue

If you feel an overwhelming sense of exhaustion, a complete lack of energy, or tired despite getting enough sleep, you’re not alone. According to a 2019 study published in the journal Nature Reviews Gastroenterology and Hepatology, fatigue affects up to 80% of people with active inflammatory bowel disease, and 50% of people in remission.2 That’s because it can be caused by everything from inflammation to nutritional deficiencies to medication side effects, or all three.

Weight loss and malnutrition

Speaking of nutritional deficiencies, unintended weight loss and malnutrition can occur with ulcerative colitis for a few reasons. Severe diarrhea and blood loss can lead to dehydration or an iron deficiency, while abdominal pain and nausea can make you lose your appetite. You may also avoid eating at times to stop yourself from having to go to the bathroom as often. These things can then lead to weight loss.

Dehydration

Again, dehydration is a concern if you are having severe diarrhea. When you have diarrhea, your body loses lots of fluids along with nutrients and electrolytes, like sodium, potassium, magnesium, and zinc, according to the Crohn’s and Colitis Foundation. This can make you feel dizzy, fatigued, and cause a headache.

Nausea

With all that’s going on in the digestive tract with ulcerative colitis, nausea can sometimes be an issue. This occurs more often when symptoms are severe, or if the inflammation affects more of the large intestine, according to the NIDDK.

Joint pain

Sometimes people can get ulcerative colitis symptoms outside of the bowels, which are called extraintestinal complications. Arthritis is actually the most common one, occurring in up to 30% of people with IBD.3 These complications occur due to the immune system being out of whack, which then causes inflammation in areas outside of the bowels.

Skin problems

The second most common type of extraintestinal complication is skin disorders, including rashes and other skin issues, like ulcers on the skin. These affect up to 20% of people with IBD.4 Like joint pain, skin issues can occur because the immune system overreacts, causing inflammation outside of the bowels.

Eye issues

If you thought there is no way your eyes could be affected by ulcerative colitis, think again. According to a 2015 study published in the Scientific World Journal, when ulcerative colitis affects the eyes, it can cause eye pain and blurry vision (uveitis), which could lead to permanent vision loss if not treated right away. It can also show up as inflammation and redness in the white of the eye, which does not cause vision loss.5

Do different types of ulcerative colitis cause different symptoms?

Certain symptoms may point to different types of ulcerative colitis. These types, as outlined by the Mayo Clinic, are classified by location within the body: