Diarrhea is one of the most common symptoms of ulcerative colitis. Sometimes it can be accompanied by blood and mucus. Treatments could help manage your symptoms.
Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that causes chronic inflammation in the colon and rectum.
Diarrhea is one the most common symptoms of UC, along with abdominal discomfort and an increase in the urge to pass a bowel movement.
Living with a long-term condition like UC can feel overwhelming at times, and frequent diarrhea can affect all areas of your life.
Currently, there’s no cure for UC, but certain treatments can make flare-ups and diarrhea episodes less frequent.
Inflammation can affect the colon’s ability to absorb water and process food and waste. This can lead to diarrhea, which is when you experience
According to Crohn’s and Colitis UK, diarrhea associated with UC may appear fluffy, mushy, or entirely liquid. You may also experience bloody stools, which may be due to ulcers in the lining of the colon and rectum.
Diarrhea related to UC may also
- cramps
- abdominal pain
- urgent need to use the bathroom
- increased frequency of bowel movements, including during the night
- feeling that you haven’t completely emptied your bowels
Experts suggest that people with moderate to severe UC can experience diarrhea up to
Speak with a doctor if this occurs. Frequent diarrhea can lead to complications like severe dehydration and weight loss.
If you have UC and are experiencing diarrhea, you’re not alone.
A 2023 study highlights research based on 2020 census data estimating that over 1.2 million people in the United States are living with UC.
This is an increase from the figures the Crohn’s and Colitis Foundation of America reported in 2014 where about 907,000 people were living with UC in the United States. Among them:
- 48% were in remission
- 30% had mild disease activity
- 20% had moderate disease activity
- up to 2% had severe disease
Remission is when you do not experience UC symptoms or they’re managed and mild.
However, a flare-up is a period when you may experience more severe symptoms and frequent bowel movements. This means you may notice more watery, loose, or bloody stools than during remission.
People usually receive a UC diagnosis between ages
Regardless of when UC is diagnosed, recent research suggests that it may affect your health — physically, emotionally, and mentally — all factors that may greatly affect your quality of life.
Diarrhea can be unpredictable, highly inconvenient, and potentially embarrassing. For instance, the urgent need to use a bathroom multiple times a day can interfere with your social activities and your ability to work.
Over time, severe UC can also cause financial challenges due to:
- medications, both over-the-counter and prescription
- doctors’ visits
- diagnostic procedures
- hospitalizations
- lost earnings
If your symptoms of diarrhea are affecting your quality of life, speak with a healthcare professional. They could help develop a treatment plan to manage your symptoms.
Although inflammation associated with UC may lead to diarrhea, other factors may also cause diarrhea. According to Crohn’s and Colitis UK, examples may include:
- taking certain medications, such as aminosalicylates
- taking iron supplements
- eating certain foods, such as spicy foods, high fat foods, high fiber foods, or sugary foods
- having an infection, such as Clostridioides difficile (C. diff), formerly known as Clostridium difficile, or gastroenteritis
- having stress or anxiety
A doctor can help you identify other possible triggers. Keeping a daily journal to track what you eat, your physical activities, and stressful events may also help. In time, you may be able to identify a pattern that leads to diarrhea.
Treatment for UC aims to help keep you in remission and prevent future flare-ups. Following your treatment plan may be the most effective way to manage diarrhea.
Medications to manage UC symptoms include:
- aminosalicylates
- corticosteroids
- immune modifiers
- biologics
Sometimes a healthcare professional may recommend an over-the-counter (OTC) antidiarrheal like loperamide (Imodium) to help manage symptoms of diarrhea.
However, it’s very important to avoid using any OTC medications during a flare-up, as this can mask the underlying condition and lead to severe complications.
It’s also important to speak with a doctor if you experience any of the following symptoms, as they may require urgent medical intervention:
- fatigue
- unexplained weight loss
- six or more bloody bowel movements per day
- intense abdominal pain
- fever
Several lifestyle and dietary habits could help you manage urgent or frequent bowel movements.
According to Crohn’s Colitis Canada, examples may include:
- setting regular times to move your bowels, such as choosing convenient times so you’re not rushed
- sitting for up to 20 minutes after eating
- practicing pelvic floor exercises to strengthen the muscles around the rectum and anus
Making certain dietary changes may also help relieve diarrhea, though not everyone with UC will benefit from the same dietary changes. Keeping a diet journal may help you figure out which foods tend to make diarrhea worse and which ones may be more helpful.
Some items that can contribute to loose stools are:
- dried beans
- raw vegetables
- corn
- cabbage, spinach
- dried fruits
- processed meats
- fried foods
- fructose
- caffeine, alcohol, and carbonated beverages
Foods that may help some people manage diarrhea are:
- boiled or mashed potatoes
- bananas
- rice, noodles, pasta
- peanut butter
- white bread
- lean meats
Eating more frequent, smaller meals throughout the day may also help.
Frequent diarrhea associated with UC may cause your body to lose fluids, sugars, and essential salts. This may increase your risk of dehydration, which could be severe if left untreated.
Symptoms of dehydration may include:
- increased thirst
- dry mouth
- dark-colored urine
- less frequent urination
- headache
- lightheadedness
- muscle cramps
- dry skin
Here are things you can do to replace lost fluids and nutrients:
- Drink plenty of water.
- Drink an oral rehydration solution or drinks that contain electrolytes and salts.
- Include foods with sodium and potassium in your daily diet.
It’s important to stay well hydrated, especially if you have UC. According to Crohn’s and Colitis UK, dehydration can eventually lead to kidney stones, liver damage, and muscle and joint damage.
Signs of a medical emergency due to dehydration may include:
- confusion, disorientation
- blue lips
- rapid breathing, rapid pulse
- inability to wake up
Diarrhea is a common symptom of UC and one that can interfere with daily life.
Finding the right treatment for UC can help reduce flare-ups. Medications and lifestyle alterations can help you tackle individual symptoms, such as diarrhea.
If you have frequent or severe diarrhea, consider speaking with a doctor to discuss whether you need to make any changes to your treatment plan.