Main symptoms of ulcerative colitis

Ulcerative colitis is an inflammatory condition affecting the lining of the large bowel. Symptoms may come in flares, with periods when they ease. Bowel movements can be loose and urgent, and some people feel they need to pass stool even when little comes out. Rectal bleeding, mucus, reduced appetite, nausea and unintentional weight loss can also occur. Anaemia or ongoing inflammation may contribute to fatigue. Symptoms vary with the area and activity of inflammation, so a pattern of symptoms is more useful than one symptom alone.

Record how often you open your bowels, whether you see blood or mucus, your pain, temperature, appetite and any recent medicines or travel. Arrange a medical assessment if symptoms persist, recur or interfere with daily activities. A clinician may ask about family history and arrange stool or blood tests; further assessment can help distinguish inflammatory bowel disease from infection or other bowel conditions. Do not stop prescribed treatment without advice. Reading about [Ulcerative Colitis](/conditions/ulcerative-colitis/) and [GP Consultation](/treatments/consultations-and-assessment/gp-consultation/) can help you prepare.

Seek urgent medical help for heavy or persistent rectal bleeding, severe or worsening abdominal pain, a swollen abdomen, repeated vomiting, inability to keep fluids down, faintness, confusion or signs of dehydration such as very little urine. A high temperature with a marked flare or rapid deterioration also needs prompt assessment. These warning signs can signal a serious complication or another acute illness and should not be judged by symptom frequency alone.

Ask which tests are appropriate, how to recognise a flare, what treatment plan to follow, and which medicines or foods could worsen symptoms. You can also ask whether [Abdominal Pain](/symptoms/abdominal-pain/) or [Diarrhoea](/symptoms/diarrhoea/) needs separate assessment and whether [Colorectal Cancer Screening](/treatments/diagnostics-and-screening/colorectal-cancer-screening/) applies to you.