What should you know about IBD ulcerative colitis?

Symptoms can come and go. Common problems include loose or frequent stools, blood or mucus in the stool, abdominal pain, urgency and tiredness. The condition affects the colon and rectum, unlike Crohn's disease, which can affect other parts of the digestive tract.

Ulcerative colitis involves an overactive immune response in the bowel lining. The inflammation may be limited to the rectum or may extend further through the colon. A flare is a period when bowel inflammation and symptoms become more active; remission means symptoms are reduced or absent, although follow-up may still be needed.

Diagnosis is based on your symptoms, examination and tests. A clinician may arrange blood tests, stool tests and a camera examination of the bowel, with tissue samples when appropriate. These checks also help distinguish ulcerative colitis from infection and other causes of diarrhoea.

Arrange a GP consultation if you have ongoing diarrhoea, blood in your stool, repeated urgency or abdominal pain. Keep a brief record of stool frequency, bleeding, pain, fever, weight change, food triggers and medicines; this gives the clinician a clearer picture.

Treatment is tailored to the affected bowel area and how active the inflammation is. It may include anti-inflammatory medicines, medicines that modify immune activity, short courses of steroids for a flare, or surgery when medicines do not control complications. Take prescribed treatment as directed and do not stop it suddenly without medical advice.

During symptoms, drink regularly and choose foods you tolerate. A dietitian can help if eating becomes difficult or your weight is changing. Avoid using anti-diarrhoea medicines during a severe flare unless a clinician has advised you.

Seek urgent medical help for heavy or persistent rectal bleeding, severe or worsening abdominal pain, a swollen abdomen, repeated vomiting, faintness, confusion, or inability to keep fluids down. A high fever with a marked change in bowel symptoms also needs prompt assessment.

A severe flare can cause dehydration, anaemia or serious bowel inflammation. If you already have ulcerative colitis, follow your personal flare plan and contact your IBD team or urgent care service when symptoms are rapidly worsening.

Ask which tests are needed to confirm the diagnosis, which part of the bowel is affected, how you should recognise a flare, and what to do if a medicine causes side effects. You can also ask whether you need a specialist referral, nutritional support, bone-health checks or bowel surveillance tailored to your history.