The severity of symptoms can also vary person to person. According to the NIH, most people with ulcerative colitis symptoms first experience mild to moderate signs of the disease, with about 10% experiencing severe symptoms like frequent bloody bowel movements. No matter the severity, most people have periods of remission (when they don’t have symptoms), which can last for weeks or years, the NIH says, and periods of “flares,” or active disease.
Which symptoms you deal with can also depend on the location of your UC. Speaking of…
Types of ulcerative colitis
Doctors typically classify ulcerative colitis by where it shows up in your digestive tract. These are the main forms, per the Mayo Clinic:
Ulcerative proctitis: With this form of the condition, which tends to be the mildest, a person has inflammation in the area closest to the rectum. Rectal bleeding may be the only sign of the disease.
Proctosigmoiditis: Inflammation with this form of the disease involves a person’s rectum and lower end of the colon. Symptoms can include bloody diarrhea, abdominal pain, and an inability to go despite feeling like you need to.
Left-sided colitis: This involves inflammation from the rectum, through the lower colon, and into the descending colon. In addition to bloody diarrhea and abdominal pain on the left side, you may also experience weight loss.
Pancolitis: This usually impacts a person’s entire colon, causing bloody diarrhea that can be severe, abdominal pain, fatigue, and severe weight loss.
Acute severe ulcerative colitis: This form of colitis is rare, and it affects the entire colon. It can cause severe pain, diarrhea, bleeding, fever, and an inability to eat.
Complications of ulcerative colitis can be dangerous, which is why it’s so important to get treatment.
People with ulcerative colitis can get very sick from weight loss and malnutrition, and develop anemia (low blood counts) which can cause issues like fatigue, Dr. Ananthakrishnan says. In more severe cases, ulcerative colitis can affect a person’s ability to function normally, he says. It can also put people at risk of toxic megacolon, which can cause the colon to burst and can expose them to a systemic infection like sepsis, Darrell Gray, M.D., M.P.H., a gastroenterologist at the Ohio State University Wexner Medical Center, tells SELF. People with more severe cases are also at an increased risk of developing colon cancer and other serious health conditions, like liver disease, Rudolph Bedford, M.D., a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, California, tells SELF.
Ulcerative colitis can be deadly if you have a severe case that’s left untreated, Dr. Bedford says. The possibility of an ulcerative colitis diagnosis might be scary (or you might feel embarrassed by your symptoms), but you shouldn’t let any of that keep you from seeking the help you need. With a doctor in your corner, you can find the best ways to manage your ulcerative colitis together. (And if you do get a diagnosis? We’ve got advice for that too.)
Depending on your ulcerative colitis symptoms, the disease isn’t always easy to diagnose, especially since they can be mild at first. “These symptoms can be subtle and representative of other things,” Dr. Gray says.
However, doctors can conduct blood tests, stool tests, and a colonoscopy to give you a proper diagnosis. If you have more serious symptoms, your doctor might also perform a standard X-ray of your abdominal area or a CT scan of your abdomen or pelvis to check for more serious complications (like a perforated colon), per the Mayo Clinic.
The most common ulcerative colitis treatments are oral medications called 5-aminosalicylates, often used for milder cases, Dr. Ananthakrishnan says. Depending on the location of your ulcerative colitis, you might instead take them as an enema or suppository. Your doctor might also prescribe short-term corticosteroids like prednisone or budesonide in moderate to severe cases, according to the Mayo Clinic.