Let's Talk About the Signs and Symptoms of Ulcerative Colitis

Maybe you’re havingbelly woes and you’re wondering if it could be something serious—like ulcerative colitis (UC). Or maybe you’ve already been diagnosed and you’re not sure if these weird new symptoms are UC-related—or something else. What’s “normal” with UC varies from person to person, but we’re here to help you understand the basics when it comes to the many potential signs and symptoms of this type of inflammatory bowel disease (IBD). No matter what you’re going through—from digestive issues like diarrhea to other problems such as fever, joint pain, and beyond—we’ll help you navigate your symptoms so you can get the best care possible.

UC Symptoms

Our Pro Panel

我们去了一些国家的顶级UC专家，为您带来最具科技和最新信息。

Aline Charabaty Pishvaian, M.D.

Director of the Inflammatory Bowel Disease Center

Sibley Memorial Hospital

Washington, D.C.

Jason Schairer，M.D.

Senior Staff Gastroenterologist

Henry Ford Inflammatory Bowel Disease Center

Detroit

梅根伊丽莎白Riehl，Psy.d.

Clinical Health Psychologist

University of Michigan

Ann Arbor, Michigan

What Are the Signs and Symptoms of Ulcerative Colitis?

首先,让我们回顾一下:is溃疡性结肠炎, anyway? Thiscondition occurs when your large intestine—that includes your colon and your rectum—is chronically inflamed。Somehow, your immune system’s signals got scrambled, so the body ends up attacking healthy cells as if they’re foreign invaders. The resulting inflammation is the root cause of most of its symptoms, too.

While most people associate the digestive system and intestinal issues with UC, not all UC symptoms stem from the large intestine. Because the inflammation of UC is systemic, it can affect your entire body, leading to problems like joint pain, extreme fatigue, and more—not to mention the stress and anxiety that can come with dealing with a serious chronic disease.

Here’s a quick list of the main symptoms:

• Blood or pus in your stool

• 频繁的腹泻

• Tenesmus，或者当你有突然和不断的感觉时，你需要有一个肠道运动

• Abdominal pain or discomfort

• Weight loss

• Fever

• 疲劳

• 减少胃口

Now, let’s do a deeper dive into some of the most common symptoms.

What Are the Digestive Symptoms of UC?

Many UC symptomsareintestinal. The big three? Blood, diarrhea, and pain. So, yeah, really fun ones. Here are the specifics:

• Blood or pus in your stool.One of the most common signs that you may have UC is seeing blood or pus (white or yellow mucous) in your poo—which can be a scary experience. Blood in your stool may look like bits of red mixed in with the brown, or the poop may appear black and tarry. You might even notice blood on your toilet paper when you wipe. So, what do you do if you see blood in your toilet bowl? Well, experts say blood in the stool总是warrants a trip to the doctor. Many times, it ends up being something mild and easy to treat, like hemorrhoids. But it’s important to see your doctor to rule out other causes and consider the possibility of UC. Also, it’s possible to have blood in your stool that isn’t visible to the naked eye—that’s one reason why doctors often take a stool sample when diagnosing UC. That way they can get a closer look and make sure they’re not missing this key sign that frequently comes with UC.

• 频繁的腹泻。You may find yourself running to the bathroom with ongoing diarrhea. We’re not talking about your typical bout of diarrhea—with UC, the onslaught may last more than four days (sometimes for weeks at a time), wake you up in the middle of the night, and strike more than four times per day. This symptom can be one of the most difficult for people with UC to deal with, since it can interrupt daily life and be downright embarrassing. If you realize that you’re always clocking the location of the nearest bathroom in your travels, or you find yourself canceling plans for fear of having diarrhea, this could be a sign that you have something more serious going on—like UC.

  Some people with UC also have what’s calledtenesmus。That’s perhaps a more polite term to describe the constant feeling that you need to poop. And then sometimes, when you try to go, nothing comes out—or the urge doesn’t go away even after you’re done. Diarrhea can happen to anyone, but start paying attention if yours worsens, lasts longer than a few days, or wakes you up at night.

• Abdominal pain.Though less common than bloody stool and diarrhea, abdominal pain is another possible symptom of UC. Kinds of pain include general discomfort (like a squeezing, bloated feeling), constipation, or sharp abdominal cramps. Watch for a swollen, distended stomach and tenderness to the touch—these could be signs that your inflammation is severe.

How Do I Gauge Symptom Severity?

UC symptoms can range from mild to severe, and your doctor will take all your symptoms into account when assessing the severity of your case. For example, if you’re experiencing more than six loose, bloody stools a day and your abdomen is swollen and tender, your UC is likely severe. But if you’re experiencing four or fewer loose stools a day with only mild abdominal pain, your UC may be considered mild.

并记住：症状可能因人与人而异。随着时间的推移，当您学习管理UC时，您将了解您的“正常”版本是什么。很重要的是要知道你的UC可以随着时间的推移而改变 - 它可能会变得更糟（称为“进步性”疾病），或者你可能会发现你比最初的症状不同。另一方面，您的UC也可能随治疗而改善，导致症状几乎没有症状时的缓解期。这是UC治疗的真正目标 - 让您的疾病和症状控制到他们几乎没有引人注目的地方，如果有的话。

UC的不消化症状是什么？

Less talked about are the UC symptoms beyond the digestive tract—called “extraintestinal symptoms” in the world of IBD. Some research, such as this review inWorld Journal of Gastroenterology, finds that these farther-flung symptoms are a sign of greater disease severity. Here’s what to watch for.

• Weight loss.一个标志你应该前往医生进行评估，因为UC是任何无法解释的减肥。如果你没有积极尝试减肥，但规模上的数量不断下降（超过5％的体重在不到六个月内），使得呼叫 - 它可能是UC或其他需要治疗的健康问题。

• Flu-like symptoms.Feeling under the weather pretty much constantly? That can be UC, too. Some people with UC deal with fevers, extreme fatigue, achiness, and reduced appetite. If you’re experiencing these symptoms, see your doctor. For fatigue, the solution may be as straightforward as working to improve your sleep quality. It’s not uncommon for UC symptoms to interrupt sleep (pooping all the time can do that)—so getting a handle onthosedisruptions with treatment can help you get some proper shut-eye, which will improve your energy levels and help you feel better overall. It’s basically a positive feedback loop!

• Joint pain.多达40%的IBD患者可能经历疼痛joints due to that body-wide inflammation, which can cook up problems head to toe. Most commonly, people with IBD experience外周关节炎, a form that typically affects large joints like the hips, shoulders, and knees. No surprise here: Joint symptoms usually flare up whenever your digestive symptoms do.

  Some people also experienceaxial arthritis，这影响了你的下背部。这种关节炎的第一个迹象可能是早晨的僵硬或腰痛，如果你坐着或长时间坐下来变得更糟，并且随着活动而改善。不太常见的是，UC的人可能在较小的关节中具有关节炎，就像手中的那些。幸运的是，许多相关症状改善了整体UC症状的治疗。您的医生还可以推荐物理治疗和温和的运动计划来瞄准这些问题。轴向关节炎伴随着IBD疾病活动的独立课程。

• Skin problems.UC runs deep, starting within the lining of your colon. But systemic inflammation can also affect the outermost layer of your body: your skin. The most common skin issues for people with IBD are:

  • Erythema nodosumis characterized by painful, red nodules on the skin, especially on the shins, affects about 10% of people with UC.

  • pyoderma gangrenosumis similar to erythema nodosum in that it presents with nodules on the skin—but in this case, these lumps can turn into painful ulcers. It affects about 0.5% to 2% and higher in UC than in Crohn’s disease, according to a study in生理学的前沿。

  • Pruritusis itchy skin. According to a2020 study published in the journalCrohn’s & Colitis 360found that people with IBD—especially if they have active disease—often have pruritus and/or dry skin.

• Eye problems.It’s bad enough that your butt feels like it’s on fire, but your eyeballs may, too. UC can cause redness, inflammation, and dryness.

When to Call Your Doctor

If you’re having any of the above UC symptoms, especially bloody stool, endless diarrhea, or severe pain, make an appointment with your primary-care doctor. It could always be something other than UC, but it’s important to get it checked out.

The sooner you treat UC and work to stop the damage to your intestinal lining and overall health, the better. If your GP suspects UC, they will likely refer you to a gastroenterologist, which is a type of physician specializing in digestive health care. This doc can further evaluate your symptoms, run any necessary tests, and get you a diagnosis.

如果你已经被诊断为加州大学,给你打电话r gastro if you’re experiencing any increase in symptoms like bloody stools, diarrhea, and pain, along with weight loss, fatigue, and fever.

And we totally get it. Talking about UC symptoms with your doctor—or anyone!—can feel awkward or embarrassing (we are talking about poop, after all). But it’s hugely important that you’re honest about what’s going on so your doctor can get you the best treatment possible.

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Are There Different Types of UC?

When you get diagnosed with UC, your gastroenterologist may tell you that you have a certain type of UC. There are a few different subtypes, and each can have slightly different symptoms. Here’s a breakdown.

• Ulcerative proctitis.在这种类型的UC中，炎症被限制在直肠上，而不是直肠和结肠。这种类型的UC的症状包括直肠疼痛和出血以及肠道运动的紧迫感。

• Left-sided colitis.In left-sided colitis, inflammation can extend from the rectum to the splenic flexure, a bend in the colon near your spleen. Another type of UC calledproctosigmoiditisalso falls under the umbrella of left-sided colitis, and it affects your rectum and the sigmoid colon, which is the lower part of your colon. Symptoms of these types of UC include bloody diarrhea, weight loss, reduced appetite, and pain (can feel like pressure or cramping) on the left side of your abdomen.

• Extensive colitis.这种类型的UC涉及通常涉及整个结肠的炎症被称为致血炎。症状包括血淋淋的腹泻，腹痛，减肥和减少食欲。

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What Are the Complications of Ulcerative Colitis?

UC can also lead to complications, especially if left untreated or if you don’t follow the directions for your medications to a T (for example, skipping doses). Common complications of UC include:

• Rectal bleeding, which can lead to iron-deficiency anemia

• A rupture of the bowel

• Increased risk of colon cancer

• 维生素和矿物质的缺陷，这可能导致骨质缺血或骨质疏松症的形式骨质损失

• Inflammation throughout the body, such as the eyes, skin, and joints

If you’ve had surgery for UC, keep in mind there may be surgical complications as well. Talk with your doctor about any warning signs to watch for.

UC and Your Mental Health

It almost goes without saying that UC can have a major impact on your mental health. The mind-gut connection is real, meaning that everyday stress can manifest in digestive symptoms. Of course, this relationship goes both ways, too: Stress can cause GI symptoms that can cause stress… you get the idea.

What’s more is that research, like thisstudy in theCanadian Journal of Gastroenterology and Hepatology, shows that people with IBD are at increased risk of developing symptoms like anxiety and depression, and sometimes full-blown depressive or anxiety disorders.

It’s no wonder—living with a condition like UC that’s shrouded in stigma can be isolating, and the fear of symptoms flaring up unexpectedly is often anxiety-provoking and stressful. When your symptoms can interfere with your ability to go to work, go to school, or even just hang out with friends and family, it can take a serious toll on your mental health.

Building a strong support system of friends, family, and your health care team is important to remove some of that emotional burden. Working with a therapist is also a valuable option—they can teach you techniques to reduce your anxiety, transform your mindset, and more.

Meet Our Writer

Lara DeSanto

Lara is a health writer, trauma-informed art therapist, and registered associate marriage and family therapist practicing in Los Angeles. She is also a former digital editor for HealthCentral, covering Sexual Health, Digestive Health, Head and Neck Cancer, and Gynecologic Cancers. In a past life, she worked as the patient education editor at the American College of OB-GYNs and as a news writer/editor at WTOP.com.

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