The clinical picture of ulcerative colitis
Ulcerative colitis causes a general inflammatory status that causes intestinal and extraintestinal symptoms. Symptoms occur in attacks with periods of remission in between. Symptoms vary among patients according to the severity and the site of inflammation.
1. Intestinal symptoms
The main symptom of this disease is the frequent bloody diarrhea that may contain mucous or pus. Abdominal pain also occurs and may be mild discomfort or so painful bowel movements and abdominal cramps. Bloody diarrhea and abdominal pain are the characteristic features of severe attacks.
Other symptoms include:
- Frequent urgency to defecate
- Fecal incontinence
- Nocturnal defecation
- Tenesmus: urgency to defecate but without passage of stool (or too little stool)
- Chronic rectal bleeding is a dangerous problem that may cause anemia, which affects the quality of life.
- Rectal pain
- Fever, fatigue, malnutrition, weight loss, iron deficiency
- In children, ulcerative colitis causes growth retardation.
Ulcerative colitis causes life-threatening complications, such as:
- Perforated colon
- Toxic megacolon (rapidly dilated colon)
- Severe dehydration
- Severe anemia
- Raised risk of colon cancer
Intestinal symptoms classify ulcerative colitis into three grades:
- Mild: Rectal bleeding and less than four bowel motions daily
- Moderate: Rectal bleeding and more than four bowel motions daily
- Severe: Like the previous grade plus systemic (extraintestinal) symptoms and low serum albumin (due to dehydration)