Symptoms of Colitis

Colitis is a term used to describe inflammation of the colon, also known as the large intestine. The colon is located at the lower end of the digestive tract.

Colitis occurs when the mucosal lining of the colon becomes inflamed. This can happen for a variety of reasons, including infections, autoimmune conditions, ischemia (reduced blood flow to tissues), and drugs.

Learn more about the symptoms of colitis.

Frequent Symptoms

Colitis can occur for a number of reasons, which means the symptoms can vary. Types of colitis include:

• Ulcerative colitis
• Microscopic colitis
• Ischemic colitis

Ulcerative Colitis

Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) in which the colon and rectum become inflamed. The disease can vary in severity among people who have the condition.

Common symptoms of ulcerative colitis include:

• Bloody diarrhea (typically the main symptom indicative of ulcerative colitis)
• Abdominal pain
• Rectal pain
• Frequent bowel movements
• Weight loss
• Fever
• Pain in joints
• Skin rash
• Constipation
• Rectal spasm

Microscopic Colitis

Microscopic colitis is a chronic inflammatory bowel disease (IBD) that causes inflammation of the lining of the colon. Microscopic colitis presents in two forms:

• Lymphocytic colitis
• Collagenous colitis

Lymphocytic colitis means the lining of the colon has more white blood cells than is typical. The collagen layer under the colon lining is normal or sometimes slightly thicker than normal.

Collagenous colitis means the collagen layer under the lining of the colon is thicker than normal.

Both forms of microscopic colitis have the same symptoms.

Symptoms of microscopic colitis may include:

• Chronic diarrhea (commonly watery, without blood)
• Diarrhea that occurs in the evening
• Abdominal pain
• Urgency with bowel movements
• Fecal incontinence
• Weight loss
• Fatigue

Ischemic Colitis

Ischemic colitis is an inflammatory condition that happens when blood flow to the colon is reduced. Lack of sufficient blood flow means not enough oxygen travels to the colon, which can cause tissue damage.

Possible symptoms of ischemic colitis include:

• Acute abdominal cramping
• Acute abdominal pain
• Urge to have a bowel movement
• Passing of blood from the anus
• Diarrhea
• Distention of the abdomen
• Nausea
• Vomiting

Rare Symptoms

Those with colitis may also experience some rare symptoms. These can vary based on the cause of the colitis. Not everyone with colitis will have these symptoms, and they are not as common.

Ulcerative Colitis

As well as the common symptoms listed above, those with ulcerative colitis may also experience other symptoms. Some of these symptoms will occur only rarely and may occur only in individuals with severe ulcerative colitis.

These include:

• Chills
• High fever
• Dehydration
• Lack of appetite
• Weight loss
• Growth retardation (in children)

Some people with ulcerative colitis, most likely those with the severe form of the disease, may also develop generalized symptoms. These may include:

• Arthritis
• Inflammation of the joints
• Pain in the joints
• Inflammation in the joints of the spine
• Inflammation in the joints of the pelvis

Some people may also develop inflammatory skin conditions. This can involve sores that are reddish-blue and contain pus or multiple skin nodules that may be tender.

In some cases, those with ulcerative colitis may develop inflammatory eye conditions. In some cases, inflammatory eye conditions may flare up as intestinal symptoms do, or they may occur independently of colitis symptoms.

Microscopic Colitis

In rare cases, microscopic colitis may cause ulcers or perforation of the colon. This is uncommon. 

Complications

In some cases, colitis can lead to complications. This can vary based on the cause of colitis.

Ulcerative Colitis

Over time, ulcerative colitis can lead to complications throughout the body. These complications include:

• Anemia, when there are fewer red blood cells than normal
• Bone problems, like low bone mass or osteoporosis
• Problems with growth or development in children. This can include poor weight gain, short stature, slowed growth, or a delay in puberty.

In some cases, those with ulcerative colitis are at risk of serious complications that can be life-threatening. These include:

• Fulminant ulcerative colitis: Fulminant ulcerative colitis causes severe symptoms of colitis such as more than 10 bowel movements a day that are bloody. Rapid heart rate and severe anemia also occur in fulminant ulcerative colitis.
• Perforation: In some cases, ulcerative colitis can be so severe that the wall of the colon tears.
• Severe rectal bleeding: In some cases, a person with ulcerative colitis may have bleeding from the rectum that is so severe or heavy that they need emergency surgery.
• Toxic megacolon: In toxic megacolon, gas becomes trapped in the colon, causing swelling. This can be a serious and potentially life-threatening event as it can cause the colon to rupture, causing infection. Symptoms of toxic megacolon include high temperature, rapid heart rate, and abdominal pain.
• Primary sclerosing cholangitis: Primary sclerosing cholangitis (PSC) is a rare complication of ulcerative colitis and causes the bile ducts to become scarred and inflamed over time. This can lead to damage to the bile ducts and can result in liver failure.
• Colorectal cancer: Those with long-term ulcerative colitis that involves a third or more of the colon are at higher risk of colorectal cancer.

Microscopic Colitis

Microscopic colitis is less likely to lead to complications when compared with other forms of IBD.

Microscopic colitis can cause severe diarrhea, leading to dehydration and weight loss.

In rare cases, microscopic colitis can cause perforation of the colon and ulcers.

Ischemic Colitis

The most serious potential complication of ischemic colitis is gangrene. This can occur when the lack of blood flow to the colon causes tissues in the area to die. In some cases, this requires surgery.

Those with severe ischemic colitis may develop strictures (obstructions) as the colon heals.

When to See a Doctor

If you have any symptom that is troubling you, you should speak to a healthcare provider.

In particular, you should see a doctor if you have symptoms like:

• Abdominal pain that does not improve
• Blood in the stools
• Stools that look black
• Diarrhea that does not go away
• Vomiting that does not go away
• Distended abdomen

Persistent abdominal pain is not normal, and bleeding from the rectum is not normal. If you have any doubts about your health, you should speak with your doctor.

A Word From Verywell

Symptoms of colitis can be unpleasant and uncomfortable. Colitis can occur for a variety of reasons, and symptoms may vary from person to person. Symptoms can range from diarrhea to abdominal cramping and bloody stools. Some causes of colitis can lead to complications that can be serious. If you are concerned about your symptoms, you should speak with your doctor.