When should you worry about abdominal pain if you have ulcerative colitis?

Ulcerative colitis can cause cramping, urgency, frequent stools, and blood or mucus in the stool. Pain may increase during a flare, but a sudden change in intensity or pattern deserves attention. A swollen abdomen with severe pain can signal a serious bowel complication. Not every episode of pain is a flare, so infection, medicines, and other causes may also need consideration.

Follow your written flare plan and continue prescribed medicines unless your clinician tells you otherwise. Keep a record of stool frequency, bleeding, temperature, pain, and fluid intake. Contact your gastroenterology team promptly if symptoms are increasing, you are waking to use the toilet, or you cannot maintain hydration. Avoid anti-inflammatory painkillers unless specifically approved.

Seek emergency care for severe or constant abdominal pain, a swollen or tender abdomen, heavy or repeated bleeding, fever with worsening symptoms, persistent vomiting, faintness, confusion, rapid heartbeat, or inability to drink. Urgent assessment is also needed if you stop passing stool and wind while the abdomen becomes distended.

Ask how to recognise your flare pattern, which tests may distinguish a flare from infection, how to protect hydration, and which pain medicines are appropriate for you.