Symptoms
In ulcerative colitis, a distinction is made between the very typical symptoms, which can be directly attributed to the inflammatory process in the bowel, and the so-called “extraintestinal” symptoms, i.e. those that are manifested outside the bowel. – Diarrhoea: This is usually mucous and/or bloody and can occur up to 30 times a day. Combined with the diarrhoea or isolated, cramp-like pain, classically in the left lower abdomen, occurs.
Due to these frequent diarrhoea, many patients lose a lot of weight. Since vitamins and nutrients can no longer be absorbed to a normal extent, deficiencies occasionally occur. The blood loss (some patients suffer intestinal bleeding independently of their bowel movements) can also lead to more or less pronounced anaemia.
- Flatulence: Some patients with ulcerative colitis also suffer from increased flatulence. Although this is not typically part of the clinical picture, it is nevertheless more common than in healthy people. Flatulence in patients should also be taken seriously, simply because it can increase the frequency of bowel movements, which are so often necessary anyway, or give an affected person the unpleasant feeling of having to defecate again.
It is therefore also important that such patients in particular take care not to eat too many flatulent foods. – Nausea: Patients with ulcerative colitis are often plagued by nausea. Although this is not one of the main symptoms, it often occurs in combination with bloody and slimy bowel movements and cramping abdominal pain (tenesmus).
However, patients do not usually have to actually vomit. Often, however, the nausea is accompanied by a loss of appetite, which must be taken seriously, as the patients already lose a lot of weight due to the frequent diarrhoea. – Joint pain: In ulcerative colitis, a distinction is made between the typical symptoms associated with the bowel and the so-called extraintestinal symptoms, i.e. those outside the bowel.
These symptoms also include joint pain. These are caused by an inflammation of the joints and can sometimes be accompanied by limited mobility. As a rule, it is the large joints, for example the knee joint, that are affected.
In such a case, the joint pain usually comes together with an acute flare-up and disappears again when it has subsided. If, on the other hand, smaller joints are affected, they often remain permanently, regardless of the degree of activity of ulcerative colitis. Although joint involvement does not occur very frequently in the overall collective, it can severely affect the patient’s daily life and may even be perceived as worse than the actual disease, at least if it is really permanent.
- Other extraintestinal symptoms: This group mainly includes skin changes (for example aphthae or typical looking redness, the erythema nodosum), inflammation of the eye (iris or choroid) or inflammation of the liver (primary sclerosing cholangitis, PSC). Approximately 80% of all patients with ulcerative colitis experience pain during relapses, but about 20% of those affected also experience pain during the relapse-free period. The most common form of abdominal pain is in the left lower abdomen, and it is not uncommon for it to occur during or after bowel movements.
In addition, there is pain due to inflammation outside the intestine, for example in the joints. Painkillers can provide relief, but they should only be taken in consultation with your doctor, as some common and over-the-counter painkillers can trigger or aggravate relapses (for example ibuprofen). Flatulence is a common symptom in ulcerative colitis and can be very stressful for those affected.
Too much gas in the bowel leads to loud bowel sounds, abdominal pain and possibly noisy escape of the gases. In severe cases the abdomen bloats visibly (“bloated abdomen”). In addition, the gases trapped in the intestine can exert pressure on organs above the intestine and thus cause belching, loss of appetite and nausea.
The gases either enter the intestine from the outside, for example through increased air swallowing when eating, or they are produced in the intestine in increased quantities. The latter is often the case in ulcerative colitis, partly because the natural intestinal flora can be disturbed by the disease. The flatulence often improves when the disease activity decreases, which is why the treatment of ulcerative colitis is the most important measure to reduce the gases in the intestine.
In addition, it can help to eat more slowly and consciously to avoid excessive swallowing of air. The diet itself also has an influence on gas production in the bowel, fibre-rich food and carbonated drinks should be avoided in cases of flatulence. Probiotics (for example Kijimea® preparations) or household remedies such as teas made from fennel and caraway can also reduce the symptoms.
