For individuals living with ulcerative colitis (UC), a chronic inflammatory bowel disease, paying close attention to bowel habits is crucial for managing the condition and anticipating potential flare-ups. Understanding what changes in stool signify can empower patients to proactively communicate with their healthcare team and adjust treatment plans as needed. Monitoring stool patterns – including frequency, consistency, the presence of blood, urgency, and nighttime symptoms – is a powerful tool in staying ahead of UC flares, according to experts.
“No amount of visible blood, persistent diarrhea, or significant change from your ‘usual’ is too minor to mention,” emphasizes Alan Moss, MD, chief scientific officer at the Crohn’s & Colitis Foundation and a professor of gastroenterology at Boston University’s Chobanian & Avedisian School of Medicine. Recognizing the subtle shifts in bowel movements can be the first step toward effective flare management. This proactive approach to understanding ulcerative colitis symptoms is vital for maintaining quality of life.
What Does a UC Flare Glance Like in Your Stool?
One of the most common indicators of a UC flare is a change in stool consistency. Rather than being formed, stools may become loose, mushy, or completely liquid, often aligning with Bristol Stool Chart types 5 to 7. These looser bowel movements typically occur with increased urgency and frequency, potentially multiple times a day, and are often accompanied by abdominal cramping – a “strong signal” to contact a gastroenterologist, according to Dr. Moss.
The presence of blood in the stool, known as hematochezia when it’s fresh and bright red, is a significant symptom of active ulcerative colitis that should never be ignored. Supriya Rao, MD, a gastroenterologist and spokesperson for the American Gastroenterological Association, stresses, “There is no amount of blood that is considered normal in UC, even if it’s just on toilet paper.” The color and presentation of blood can offer clues about the location and severity of inflammation. Bright red blood typically indicates inflammation in the rectum or lower colon, while darker blood may suggest more extensive disease higher up in the digestive tract. Blood can appear mixed throughout the stool, coating it, or solely on toilet paper after wiping, and any amount warrants discussion with a doctor, especially if it’s persistent or increasing.
Beyond Consistency and Blood: Other Warning Signs
While changes in consistency and the presence of blood are key indicators, other stool-related changes can similarly signal a UC flare. The colon naturally produces mucus to protect its lining, but inflammation can lead to an overproduction of mucus, appearing as clear, white, or yellowish jellylike strands in the toilet or on the stool. The appearance of yellow or green mucus or pus can even point to a possible infection, Dr. Rao notes.
Tenesmus – the painful sensation of needing to have a bowel movement even when the bowels are empty – is another warning sign. Affecting as many as 30 percent of people with IBD, tenesmus indicates chronic inflammation in the lower bowel and suggests that the disease may not be fully controlled.
Additional red flags to watch for include:
- Rising urgency or a sudden, overwhelming require to find a bathroom
- Nocturnal bowel movements or waking up at night to use the restroom
- Changes in stool odor, including foul-smelling stools, which can indicate malabsorption or infection, such as Clostridioides difficile
- Abdominal pain or sudden cramping
- Rectal pain
- Fatigue and fever (even low-grade)
- Weight loss and loss of appetite
- Symptoms outside of the gut, such as joint pain, skin rashes, or eye irritation
These systemic symptoms highlight the potential for ulcerative colitis to impact areas beyond the digestive system.
Effective management of ulcerative colitis relies on open communication between patients and their healthcare providers. By diligently monitoring stool patterns and promptly reporting any changes, individuals with UC can work collaboratively with their medical team to optimize treatment and minimize the impact of flares. Ongoing research continues to refine our understanding of IBD and improve treatment options, offering hope for a better quality of life for those affected.
Disclaimer: This information is intended for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Have you found tracking your symptoms helpful in managing your UC? Share your experiences in the comments below.
