Introduction
The symptoms of ulcerative colitis are initially unspecific. The main symptom is bloody-mucilaginous diarrhoea (diarrhoea), which torments the patient even at night. Diarrhoea can be very severe, up to 30 times a day, or almost non-existent if, for example, only the anus is affected (proctitis). It is not uncommon for symptoms of fecal incontinence to occur during an episode.
Overview of the other symptoms
In addition, there may be colicky (cramping) abdominal pain, which can occur in the various quadrants of the abdomen, depending on the type of intestinal involvement. General symptoms such as weight loss, loss of appetite and nausea often accompany the event. In rare cases there is vomiting of blood.
In acute attacks, a general inflammatory reaction often occurs, which is accompanied by fever, an increase in inflammation values and inflammatory cells (leukocytes) in the blood. Some patients complain of pain during and after bowel movements (tenesmus). A relapsing-accompanying symptom of ulcerative colitis is also flatulence (meteorism), which can develop particularly as a result of temporary sugar intolerance.
The loss of blood and proteins can lead to anemia or hypoproteinemia. The inflammation of the intestinal mucosa of the colon often leads to injuries of the mucosa and the development of ulcers. As a result, affected patients suffer from bloody diarrhoea that occurs several times a day in acute attacks and can also be mucous or purulent.
Diarrhoea is known in technical terms as diarrhoea. In addition to the constant feeling of having to defecate, it is felt that the intestine is never completely emptied. Before and during stool settling, there is typically cramping abdominal pain in the lower abdomen (tenesmus).
These pains are often located on the left side. Patients with ulcerative colitis can also suffer from flatulence or faecal incontinence. Since it is almost impossible to absorb nutrients in an acute flare due to the diarrhoea that often occurs daily and in large numbers, there is often severe weight loss and a feeling of exhaustion.
The feeling of weakness can also be caused by blood loss via the stool and a resulting anaemia. In addition to diarrhoea, patients in an acute episode often suffer from nausea and lack of appetite or even loss of appetite. Although a typical leading symptom of ulcerative coltitis is bloody-mucus diarrhoea, constipation can be a complication.
Although the inflammation of the intestine in ulcerative colitis only affects the inner layers of the intestinal mucosa, the inflammation, the formation of ulcers or polyps can restrict the passage of the intestine. Due to this constriction, the food pulp can collect behind the narrowed intestinal passage and cause constipation. In such a case, the intestinal wall widens and expands, the inflammation can increase and in extreme cases the intestinal wall can even burst.
In order to avoid such and similar complications of chronic inflammatory bowel disease, early diagnosis is particularly important. In cases of frequent diarrhoea and severe abdominal pain or sudden changes in bowel movements, it is therefore recommended to consult a doctor and have the symptoms clarified by a physician. Flatulence can be an expression of an existing chronic inflammatory bowel disease.
For example, an inflammatory constriction in the bowel can cause the bowel to expand over this constriction, leading to pain and flatulence. In addition to these reasons, food intolerances, irregular eating (e.g. too few and too many meals during the day), eating late at night, drinking large amounts of fluids with meals, certain food combinations, stress or liver weakness can lead to flatulence. In such cases it can be helpful to document food intake and the occurrence of winds and to search for individual causes.
Particularly in the case of chronic inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease, additional stress on the already sensitive bowel mucosa should be avoided through certain eating habits. Although nausea is not one of the main symptoms of ulcerative colitis, it is not uncommon. Nausea often occurs in combination with loss of appetite and results in patients who are already unable to absorb much of the nutrients from the bowel during the acute phase of the disease losing additional weight and feeling tired and exhausted.
In children, and especially in the case of longer relapses and/or inadequate therapy, this can also cause growth retardation or growth disorders. A fever often occurs in an attack of ulcerative colitis. Like weight loss, diarrhoea, nausea, abdominal pain, fatigue and general malaise, fever is a very unspecific symptom of the disease, which can quickly be confused with food intolerance or a gastrointestinal infection, especially in this combination. If these “infections” occur repeatedly, a possible chronic intestinal disease should always be considered and clarified by a doctor.
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