Inflammation from UC can worsen over time, and symptoms may be mild at first. About 50 percent of people with ulcerative colitis have early symptoms, which often come and go, or are mild enough not to prompt medical attention.
1. Blood in Your Stool
Along with blood, some people notice mucus in their stool. Passing the mucus that acts as a protective lining in your gastrointestinal tract can be normal if you’re not experiencing inflammation or seeing blood alongside it. But passing blood is typically caused by the effects of inflammation in the colon and rectum. “Ulcerative colitis causes inflammation and swelling of the bowel wall,” says Dr. Fearn.
2. Loose, Watery Stools
Passing loose, watery stools three or more times per day qualifies as diarrhea, but any loose stools that aren’t usual for you also counts. Diarrhea in UC happens because inflammation affects the colon in ways that prevent fluid absorption while letting extra fluid in, making stools themselves more liquid.
3. Cramping and Abdominal Pain
This inflammation also triggers the stretch receptors of bowel nerves, which sense the presence of stool in the colon and can cause waves of cramping pain, says Fearn. At first, cramping and tenderness may feel mild and easily be passed off as gas or a pulled muscle. But if it continues, your healthcare provider may want to test for another cause, such as IBD.
4. Bloating
When these undigested foods get to your large intestine, bacteria break them down and create gas as a by-product. Besides poor digestion, excess gas and bloating in UC can also occur due to constipation, unbalanced gut bacteria (microbiome), heightened intestinal sensitivity, and food intolerances.
5. Bowel Habit Changes
“In healthy adults, the rectum can expand to hold just over 1 cup of stool,” says Alexis. “In ulcerative colitis, inflammation causes the rectum to become stiff and less able to accommodate stool over time, which leads to a more urgent need to pass stools and, in some cases, fecal incontinence.”
According to one research review, international surveys reveal that over 80 percent of people with UC report bowel urgency. Urgency is more common in people with active inflammation, but it can occur even when symptoms such as increased frequency and rectal bleeding have resolved.
“Even though ulcerative colitis is probably not the most common cause of any of these symptoms, you should definitely speak to your doctor should you experience any of them,” says Dr. Pont.
The Takeaway
- Early signs of ulcerative colitis can be subtle and easily blamed on other causes, but early detection and treatment can protect against future complications.
- The first symptoms of ulcerative colitis can include blood in the stool, diarrhea, abdominal pain or cramping, bloating, and bowel habit changes.
- If you experience these symptoms, tell your healthcare provider, who can assess the likely cause and refer you to a gastroenterologist.
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