When your gut is playing with games with you, it’s easy to blame it on stress or something you ate. But if you’re plagued with bathroom issues all the time—especially diarrhea, abdominal pain, and bleeding—it may be a sign of a more serious bowel disease, like ulcerative colitis.
Ulcerative colitis, or UC for short, is a form of inflammatory bowel disease (IBD) that causes long-lasting inflammation and ulcers in the innermost lining of your large intestine (i.e. colon) and rectum. It can come with debilitating symptoms and even lead to life-threatening complications, so getting to a doctor when you’re experiencing symptoms is key.
It’s difficult to find exact numbers on how common ulcerative colitis is, but the CDCestimates that about 3.1 million Americans (or 1.3%) suffer from IBD, which includes both ulcerative colitis and Crohn’s disease.
IBD is characterized by chronic inflammation in your digestive tract—not to be confused with irritable bowel syndrome (IBS), which is a chronic condition that affects contractions of the muscles in your large intestine. Ulcerative colitis and Crohn’s disease are two main types of IBD that share some of the same symptoms, but one main difference is where the disease occurs: Crohn’s disease causes ulceration throughout your digestive tract, while UC is mostly contained to the colon and rectum.
Ulcerative colitis can start gradually and become worse over time and, like most diseases, cases can range from mild to severe, according to the National Institutes of Health. 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.
Ulcerative colitis symptoms aren’t fun.
Those can include diarrhea with blood or mucus, abdominal pain and cramping, rectal pain and bleeding, a strong urgency to go, an inability to have a bowel movement despite feeling like you need to, weight loss, fatigue, and fever. It usually shows up first as diarrhea mixed with blood as well as an urgent need to go, Ashwin Ananthakrishnan, M.D., M.P.H., a gastroenterologist at Massachusetts General Hospital who specializes in ulcerative colitis, tells SELF. Some people can experience symptoms in other parts of their body, like joint swelling and joint aches, he says.
Depending on your ulcerative colitis symptoms, the disease isn’t always easy to diagnose, especially since they can be mild at first, Darrell Gray, M.D., M.P.H., a gastroenterologist at the Ohio State University Wexner Medical Center, tells SELF. “These symptoms can be subtle and representative of other things,” he says. However, doctors can conduct blood tests, stool tests, and a colonoscopy to give you a proper diagnosis.
Complications of UC can be dangerous, which is why it’s so important to get treatment.
Ulcerative colitis patients can get very sick from weight loss and malnutrition, and develop anemia (low blood counts) which can cause fatigue and other issues, 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 causes the colon to burst and can expose them to a systemic infection like sepsis, Dr. Gray says.
Ulcerative colitis can be deadly if you have a severe case that’s left untreated, Rudolph Bedford, M.D., a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, California., tells SELF. Patients with more severe cases are at an increased risk of developing colon cancer and liver disease, Dr. Bedford explains.
Doctors aren’t sure what causes the disease.
It’s possible that UC is caused by an immune system malfunction, according to the Mayo Clinic, but experts aren’t entirely sure. When your immune system tries to fight a virus or bacteria, an abnormal immune response may cause your immune system to attack the cells in your digestive tract as well. Genetics may also play a role, the Mayo Clinic says. However, they note, many people with the condition don’t actually have a family history of the disease.
There are different types of ulcerative colitis.
Ulcerative colitis can range from mild to severe, and it can impact different areas of 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, a patient 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.
There is no cure, but there is treatment.
The most common treatments are oral medications called 5-aminosalicylates, often used for milder cases, Dr. Ananthakrishnan says. But for more severe cases, patients are usually given immunosuppressive medications and biologics (medications derived from human and animal genes). Surgery may also be needed in some cases, Dr. Ananthakrishnan says.
So if you’re having recurring bathroom issues with any of the above symptoms, check in with your doctor or gastroenterologist. The sooner you seek help, the sooner you can treat your symptoms. “It’s possible to lead a long, healthy, and comfortable life, provided you are compliant with medications and see your doctor regularly.