Symptoms of Colitis

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Irritation or inflammation in the colon (which is the biggest part of the large intestine) is called colitis. There are many different causes of colitis, which can include both disease and infection. Some of the more common symptoms that occur with some conditions that cause colitis include abdominal pain, diarrhea, and blood in the stool.

This article will discuss frequent symptoms, rare symptoms, complications, and when to see the doctor for colitis.

Abdominal pain

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Frequent Symptoms

Colitis has several different causes, and the signs and symptoms for each will be different. However, some symptoms may occur more commonly. These can include:

  • Abdominal cramps
  • Abdominal pain
  • Blood in the stool
  • Diarrhea (with or without blood)

Other signs and symptoms that may be more common in certain types of colitis than in others include:

  • Abdominal bloating
  • Aphthous ulcers
  • Chills
  • Dehydration (which may be associated with diarrhea)
  • Eye inflammation
  • Fatigue
  • Fever
  • Joint pain
  • Skin problems
  • Weight loss
  • Vomiting

Some signs and symptoms are more specific to particular conditions that cause colitis, while others—such as diarrhea, and abdominal pain or cramping—tend to be common among most related conditions.

Additional symptoms by condition include:

  • Crohn’s disease: It’s estimated that as many as 60% of people with Crohn’s disease have inflammation in the colon. Some of the common symptoms of Crohn’s colitis are abdominal pain and bloody diarrhea, but patients should be aware that other signs and symptoms may crop up because every case is different.
  • Ulcerative colitis: The more common symptoms of ulcerative colitis are an urgent need to go to the bathroom, mucus in the stool, waking up to go to the bathroom, and abdominal cramps.
  • Clostridium difficile (C. difficile) colitis: The symptoms of C. difficile colitis are highly variable. In some cases, there may not be any symptoms (asymptomatic), but when they do occur, symptoms include fever, bloody diarrhea (although blood may not be visible and may only be detected with a stool test), and abdominal pain.
  • Microscopic colitis: Diarrhea is seen in almost all cases of microscopic colitis. It can be either constant or come and go. The diarrhea doesn’t contain blood, and the inside of the colon usually looks normal or mostly normal. Less than half of patients have weight loss or abdominal pain. Some have fatigue and have to go to the bathroom at night.
  • Ischemic colitis: The more common symptoms of ischemic colitis are acute (they come on suddenly) and include diarrhea, a swollen belly (abdominal distention), nausea, and vomiting. Abdominal tenderness may also be common.
  • Allergic colitis: The most common symptom of allergic colitis in infants is bleeding from the rectum. In some cases, if there are no other signs of disease, such as anal fissures or infection, allergic colitis might be assumed to be the diagnosis.

Rare Symptoms

These symptoms are rare in conditions that cause colitis:

  • Crohn’s disease: It is rare, but some people with Crohn’s colitis may have severe enough bleeding out of the rectum that surgery is needed to correct it.
  • Ulcerative colitis: Abdominal pain, which is different than cramps that get better after having a bowel movement, is less common in ulcerative colitis. In more serious or extensive cases of the disease, where inflammation has spread or is severe, weight loss and fever might also occur.
  • C. difficile colitis: In more severe disease, some of the symptoms of C. difficile colitis can include dehydration, abdominal distention, and swelling in the legs (peripheral edema).
  • Microscopic colitis: Most people with microscopic colitis have diarrhea several times a day when the condition is active. It’s less common, but diarrhea can occur as many as 10 times a day.

Complications

Complications of colitis can vary by condition.

Crohn’s Disease and Ulcerative Colitis

A serious but rare complication of these forms of inflammatory bowel disease is fulminant or toxic colitis, formerly called toxic megacolon.

The signs and symptoms of this condition can include bloody diarrhea along with fever, racing heartbeat (tachycardia), low blood pressure (hypotension), metabolic acidosis (a buildup of acid in the body), low urine output (oliguria), and acute kidney (renal) failure.

Toxic colitis is more common with ulcerative colitis than it is with Crohn’s disease.

C. Difficile Colitis

One of the most concerning complications of C. difficile colitis is when the infection doesn’t clear, even after treatment. This is called recurrent C. difficile infection.

This infection can lead to further problems, including:

  • Fulminant colitis with signs and symptoms including hypotension, shock, or ileus (when the natural muscle motion in the intestines slows or stops)
  • Sepsis
  • Having surgery on the intestines, including a subtotal colectomy (removing part of the colon) or an ileostomy (removing part of the colon and making an ostomy where fecal matter exits the abdomen)

Microscopic Colitis

Complications with microscopic colitis that come from the disease aren’t common. However, if steroids are used for long-term treatment, these drugs are associated with various types of complications.

Ischemic Colitis

If ischemic colitis has advanced, there could be signs of systemic inflammatory response syndrome (SIRS). SIRS may mean that a patient has tachycardia and a higher-than-normal white blood cell count (leukocytosis).

When to See a Doctor

Bleeding from the rectum or blood in or on the stool is never normal. It should always be brought up to a doctor. However, it’s not always an urgent situation.

If the cause of the bleeding is from a chronic condition (Crohn’s disease or ulcerative colitis), it should be discussed with your gastroenterologist.

In the case of new bleeding, see a doctor as soon as possible. Rectal bleeding that won’t stop is a reason to go to the emergency department. Additionally, if you feel faint from blood loss, get to the emergency department right away or call an ambulance.

Abdominal pain can come and go with ongoing conditions, like Crohn’s disease or ulcerative colitis. It’s important to discuss pain at doctor’s visits. However, if abdominal pain comes on suddenly and is severe, you should go to the emergency room or see a doctor right away.

In infants, caregivers will want to take the baby to see a pediatrician as soon as possible after seeing blood in the stool or around the rectum. Allergic colitis may be a common reason for bleeding, but it’s important to have a doctor check it out to make sure there’s not a more serious reason.

Red Flag Symptoms

Seek medical attention immediately for the following symptoms:

  • Blood in or on the stool
  • Dizziness
  • Fainting
  • Severe abdominal pain
  • Signs of dehydration
  • Vomiting that won’t stop

Summary

The most common symptoms of colitis are diarrhea, abdominal cramps, abdominal pain, and blood in the stool. Other symptoms vary by the condition causing the colitis. Blood in the stool is always a reason to contact your healthcare professional.

A Word From Verywell

When colitis is mentioned, many people may think of ulcerative colitis. However, the condition can be due to causes that range from common or not serious to those that are life threatening.

Most of the time, the symptoms of colitis won’t seem like an emergency, but with bad stomach pain—especially when it’s coupled with other symptoms that are worrying, like feeling faint—the best idea is to see a doctor right away. 

A doctor will likely look at the rectum or do a rectal exam, and may even move on to scheduling other tests to look inside the colon. These tests can seem embarrassing, and there can be a temptation to put them off. However, it’s important not to ignore symptoms, especially bleeding.

Treatments are available for the different forms of colitis. They can help get the symptoms under control and get you back to a better quality of life. 

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9 Sources
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