About this condition
Ulcerative colitis causes inflammation and ulceration of the lining of the large bowel. People may have frequent loose stools containing blood or mucus, urgency and abdominal pain. More active disease can cause bowel movements at night, fatigue, anaemia or fever.
Clinical features
Blood in the stool must not automatically be labelled as haemorrhoids or irritable bowel syndrome. Ulcerative colitis differs from Crohn’s disease in its distribution and pattern of inflammation, while infectious colitis can produce similar symptoms. Proper investigation is needed.
Important differences and warning signs
A gastroenterologist assesses the severity and extent of inflammation through history, laboratory tests and endoscopy with biopsies. Stool testing may be needed to exclude infection. Faecal calprotectin and other markers are helpful but must be interpreted alongside the clinical picture.
Assessment and individual care
Treatment aims to induce and maintain remission while avoiding uncontrolled use of steroids. Medicines depend on the extent, activity and prior response to treatment. Severe flare-ups may require hospital care. Do not stop maintenance therapy solely because visible bleeding has settled.
Related information: Crohn’s disease; Persistent diarrhoea.
Signs and symptoms
- Frequent loose stools with blood or mucus and urgent or painful bowel motions.
- Abdominal discomfort, night-time stools, fatigue and possible weight loss.
- More severe flares may involve fever, anaemia, dehydration and worsening general health.
Diagnosis and tests
Clinical review, blood and stool tests, and colonoscopy with biopsies help confirm and assess disease. Infectious causes may need excluding; inflammation markers do not replace clinical judgement.
Care and treatment approaches
Individual treatment controls inflammation and maintains remission. Steroids should not be used without supervision; monitoring may be needed even when visible bleeding stops.
When to seek urgent care
Frequent bloody diarrhoea with fever, severe pain or abdominal swelling, fainting or marked dehydration may signal a serious flare. Seek emergency care by calling 103.
Frequently asked questions
How is ulcerative colitis different from IBS?
Ulcerative colitis causes inflammatory injury to the bowel lining; IBS does not cause that type of structural inflammation.
Is follow-up necessary when there is no blood?
Yes. Symptoms do not always reflect inflammation accurately; your clinician will advise on monitoring.
May I stop medication as soon as I feel better?
No. Stopping maintenance treatment without medical guidance can increase the risk of another flare.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
