What should you know about extensive ulcerative colitis?

Ulcerative colitis affects the inner lining of the colon and rectum. In extensive disease, inflammation reaches beyond the rectum and left side into a wider length of the colon. It may cause diarrhoea, urgency, abdominal pain, tiredness or blood and mucus in the stool. Symptoms can come and go as flares and quieter periods, and their intensity does not by itself show how much inflammation is present.

A clinician may review your symptoms, medicines, blood tests, stool tests and bowel examination. A colonoscopy or other assessment can help define the affected area and guide treatment. Extensive disease can need a long-term plan even when you feel well.

Arrange a GP Consultation if symptoms are new, changing or interfering with daily activities. Keep a brief record of stool frequency, urgency, bleeding, pain, fever, food triggers and medicines. Take prescribed treatment as directed and do not stop it suddenly without advice.

Drink regularly, particularly during diarrhoea, and choose foods you tolerate while a flare is being assessed. Ask about a personalised plan for monitoring, vaccinations, bone health and colorectal cancer screening. Seek advice before taking anti-inflammatory pain medicines or anti-diarrhoeal products, because some can be unsuitable during a flare.

Get urgent medical help for severe or rapidly worsening abdominal pain, a swollen abdomen, repeated vomiting, faintness, confusion, high fever, heavy rectal bleeding or inability to keep fluids down. These signs can indicate serious illness or dehydration and should not wait for a routine appointment.

Contact your clinical team promptly if bowel movements become much more frequent, bleeding increases, or you develop marked weakness. A flare may require assessment and a change in treatment; do not try to manage a severe flare alone.

Which part of my colon is affected, and how will you monitor inflammation? What should I do if symptoms suddenly worsen? Which medicines, pain relievers and foods should I avoid during a flare? When should I arrange colorectal cancer screening?