Ulcerative colitis (UC) is a chronic (long-term) inflammatory condition primarily affecting the large intestine (the bowel and rectum).1,2
In ulcerative colitis, the inner lining of the large intestine (also called the colon) and rectum can become inflamed, causing ulcers, which may bleed and produce mucus.3 The colon then can’t absorb liquid effectively, leading to diarrhoea. It also can’t hold as much waste as normal, so bowel movements can be more frequent (six or more times a day).3
The symptoms of ulcerative colitis depend on how much of the colon is inflamed and how severe the inflammation is, and they can change over time. Having weeks or months with few or no symptoms is known as ‘remission’ and times with active symptoms are relapses or ‘flare-ups’. The impact on everyday life can be significant.2
The most common symptoms are:2,3
Your poo may be looser than normal, more frequent than is usual for you, and blood or mucus may be present
Cramping pains in the lower abdomen
Extreme tiredness, raised temperature, feeling feverish
Bleeding from the anus, blood in your poo
Difficulty passing poo or completely empty the bowel
You may eat less when you feel unwell, and anaemia is likely if you are losing blood in your poo
UC is divided into three main types according to how much of the large intestine is affected. The type of UC can affect which symptoms you have, and which treatment you are offered.3
Affects the rectum, the last part of the bowel
Affects the rectum and the left side of the colon (the distal or ‘descending’ part of the colon)
The whole colon is affected
In severe ulcerative colitis, patients can develop a narrowing in the bowel (a stricture) which may require surgery.
In some rare cases, serious complications can occur, such as toxic megacolon (the gut wall gets thin and fills with gas) which carries risk of a perforation or rupture in the bowel.3
Complications of UC that affect areas outside the digestive tract are sometimes called ‘extraintestinal’ symptoms, such as:3
Always mention any new or changing symptoms you have to your doctor – even if they are not related to UC they should be addressed if they affect your quality of life.
You can find out more about inflammatory bowel disease from these independent organisations
The Crohn’s & Colitis UK website provides information on a range of issues relating to both Crohn’s disease and ulcerative colitis, with helpful guides about the conditions, how they are treated and how to live with them. The charity provides a range of other support, including helpline services, local volunteer networks and an active membership community of over 40,000 people
IBDrelief provides information about various aspects of all types of IBD. It provides help with understanding the disease, its treatments and living with IBD, and shares first-hand accounts from people with IBD
*IBDrelief patient survey data from 167 respondents with IBD in the UK. 58% of respondents who did not discuss emotional wellbeing with their consultant gave a lack of time as the reason.4
CD = Crohn’s disease; IBD = inflammatory bowel disease; UC = ulcerative colitis.