The symptoms of ulcerative colitis vary according to the extent and severity of the inflammation.

Mild disease

Inflammation is usually limited to the rectum or recto-sigmoid area, and causes diarrhoea, rectal bleeding or both. Mild ulcerative colitis can be mistaken for haemorrhoids.

Moderate disease

Symptoms become more severe:

• Diarrhoea is a major feature with frequent loose stools containing blood.
• Crampy abdominal pain which may be relieved by passing a motion.
• Increased inflammation leads to general symptoms of mild fever, tiredness, fatigue, poor appetite and weight loss.
• Symptoms may arise elsewhere in the body, e.g. arthritis, inflammation of
• the eye or skin.

Severe or fulminant disease

The onset is sudden with severe symptoms including:

• Profuse diarrhoea with constant rectal bleeding.
• High fever.
• Tenesmus (a constant desire to have the bowels opened).
• Loss of appetite and weight.
• Fatigue and weakness.
• Distended (swollen) abdomen.
• Abdominal cramps and tenderness over the colon.