Digestive Health Inflammatory Bowel Disease Diagnosis IBD Guide IBD Guide Overview Symptoms Causes Diagnosis Treatment Diet Symptoms of Inflammatory Bowel Disease (IBD) Crohn's disease, ulcerative colitis, and indeterminate colitis By Amber J. Tresca Amber J. Tresca Facebook LinkedIn Twitter Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16. Learn about our editorial process Updated on July 28, 2022 Medically reviewed by Shadi Hamdeh, MD Medically reviewed by Shadi Hamdeh, MD Shadi Hamdeh, MD, is a board-certified gastroenterologist. He is an assistant professor of medicine at the University of Kansas Medical Center and is based in Kansas. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Frequent Symptoms Rare Symptoms Complications When to See a Healthcare Provider Frequently Asked Questions Next in IBD Guide Causes and Risk Factors of Inflammatory Bowel Disease Inflammatory bowel disease (IBD) involves ongoing inflammation of all or part of your digestive tract. Three conditions are categorized as IBD—Crohn's disease (CD), ulcerative colitis (UC), and indeterminate colitis (IC)—with the most prevalent symptoms of blood and mucus in the stool, abdominal pain, unintentional weight loss, and diarrhea. Many other symptoms may be present as well, and the pain may affect different areas of the digestive system, depending on the disease. Your specific set of symptoms can help your healthcare provider determine whether you have IBD and, if so, which type. Frequent Symptoms Verywell / Brooke Pelczynski IBD is a painful condition and some of its symptoms can be worrisome. While there's a fair amount of overlap between the different types of IBD, each has its own potential set of symptoms. IC is diagnosed when it's not clear whether the condition is Crohn's or ulcerative colitis because the disease does not fit the whole picture of each disease, so any combination of symptoms can be seen in IC. IBD Symptoms by Disease Symptoms CD UC IC Abdominal pain X X X Cramping X X X Bloating X X X Flatulence X X X Nausea X X X Diarrhea X X X Bloody stools X X X Stomach pain X X Poor appetite X X X Unintended weight loss X X X Mouth sores X X Anal itch X X Fistulas X X Fissures X X X Abscesses X X Fecal incontinence X X Intestinal ulcers X X X Urgent bowel movements X X Mucus in the stool X X X Rectal pain X X Rectal bleeding X X X Feeling of incomplete evacuation X Rectal Bleeding Bleeding from the rectum, or seeing blood in the stool, is never a normal occurrence, and it is one of the symptoms of IBD. Blood in the stool is a common symptom of UC and IC. It's less frequent in Crohn's disease. There are times when it can be a serious concern, leading to significant blood loss. Signs and Symptoms of Ulcerative Colitis Mucus in the Stool Mucus is a normal part of stool, but it usually isn't obviously visible. and it is not always a cause for alarm. If you have enough mucus in the stool that you're aware of it, there could be several reasons why. People with ulcerative colitis or Crohn's disease sometimes pass visible amounts of mucus in their stool, either as a result of ulcers in the colon or possibly due to a fissure. People who have had surgery for ulcerative colitis and have a j-pouch (ileal pouch-anal anastomosis, or IPAA) may also pass mucus, which could be a sign of a condition called pouchitis. Abdominal Pain Abdominal pain (usually described as stomach pain) can be a symptom of many different diseases. People with ulcerative colitis tend to have cramp-like pain that is located in the lower-left portion of the abdomen.People with Crohn's disease tend to have pain in the middle or lower-right abdomen (although pain could show up in other parts of the abdomen, too). Not everyone with IBD has pain, and the pain may come and go, sometimes occurring after a meal or relieved by having a bowel movement. Persistent Diarrhea Diarrhea has many causes, and even healthy adults may have diarrhea a few times a year. Often, diarrhea resolves on its own, and the cause may go undiscovered. Persistent diarrhea lasting more than three days can be a sign of a problem that might need treatment. People with IBD often have episodes of "explosive diarrhea" several times a day. This type of diarrhea is just as the name implies—rapid, sudden, and severe. This could be anywhere from three up to 10 or even 20 watery bowel movements daily. Unintended Weight Loss Losing weight without restricting calories or exercising is usually a sign of a medical issue. Diarrhea, lack of appetite, and active inflammation resulting in protein-losing enteropathy can result in unintended weight loss. Your healthcare providers might recommend that you gain weight while in remission from IBD. Make sure to do this in a healthy way, by eating fresh, nutrient rich food that's not processed, Rare Symptoms In rare cases, some people with IBD may also present with: FeversFatigueJoint painSkin rashesVision changesRed eyeIncreased menstrual symptomsFlare-ups of IBD symptoms before or during a menstrual period Your medical team should be able to help you manage these symptoms. Complications IBD is hard on your intestines and various systems in your body. Over time, and especially if treatment is delayed or inadequate, some people develop serious complications. Potential complications of IBD include: Bowel obstructionBowel perforationIntestinal abscessesIntestinal fistulasIntestinal fissuresToxic megacolonColorectal cancer Some complications that may strike outside of the digestive system include: Delayed growth (in children)Eye diseaseArthritis (especially seronegative spondyloarthropathy)OsteoporosisIncreased risk of gallstonesIncreased risk of kidney stonesNeurological symptoms, which can be severeAnemiaBlood and circulatory problemsMouth ulcersDifficulty getting pregnant When to See a Healthcare Provider If you're experiencing ongoing or severe digestive symptoms, you should see your primary care physician. Due to the difficulties involved in the diagnosis, you may be referred to a gastroenterologist. Significant abdominal pain could mean many things and should be checked out by a healthcare provider as soon as possible. Don't assume this is due to IBD. If it's accompanied by vomiting, nausea, and fever, it could be a sign of a bowel obstruction, which requires immediate medical care.Any blood in the stool should always be checked out by a medical professional right away. The blood loss of UC and IC can be significant. If it continues or is accompanied by diarrhea, pain, or vomiting, see a practitioner immediately.If the mucus in stool is accompanied by abdominal pain, vomiting, or diarrhea, see a healthcare provider right away to get it checked out.Suddenly losing weight unexpectedly is a reason to talk to a practitioner, especially if there is also ongoing diarrhea, vomiting, or a lack of appetite.If diarrhea doesn't resolve on its own and is also accompanied by abdominal pain, blood in the stool, weight loss, fever, or other symptoms, see a healthcare provider as soon as possible. If abdominal pain is severe or rectal bleeding is substantial, you may have a serious condition that needs emergency medical treatment. When to Call 911 If you experience any sudden or dramatic changes in your condition or the following symptoms, go to the emergency room or call 911: Severe abdominal pain that lasts for more than one hour Significant or new rectal bleeding Persistent vomiting, especially if you've stopped having bowel movements Drastic changes in bowel movements without any passing of gas High temperature, especially if taking corticosteroids or other medications that might be affecting your immune system A Word From Verywell IBD symptoms can be scary and a proper diagnosis can take some time. That may be frustrating, but each IBD requires different treatments, so it's important to work with your healthcare provider to figure out exactly what's going on in your digestive system and get started with the right course for you. Doing so can help minimize the effects of the disease on your daily life. Frequently Asked Questions What are the general symptoms of inflammatory bowel disease? Inflammatory bowel disease (IBD) is an umbrella term used to describe three distinct diseases affecting the digestive tract: Crohn's disease, ulcerative colitis, and indeterminate colitis. Symptoms commonly seen with all three of these diseases include:Abdominal painAbdominal crampingDiarrheaPoor appetiteBloody stoolsRectal bleedingWeight loss How do symptoms of Crohn’s disease and ulcerative colitis differ? Crohn’s disease (CD) can affect the entire gastrointestinal tract from the mouth to the anus, while ulcerative colitis (UC) is limited to the colon and rectum. As such, CD may cause mouth sores and stomach pain that UC doesn’t, while UC can cause rectal pain, significant rectal bleeding, and bowel urgency that CD doesn’t. How do symptoms of indeterminate colitis and ulcerative colitis differ? Indeterminate colitis (IC) is the term used when the features of the disease cannot be clearly attributed to either Crohn’s disease (CD) or ulcerative colitis (UC). It may be that an intestinal ulcer is found, but it doesn’t involve mucosal tissues as UC typically would. Or there may be bowel urgency, intestinal ulcers, and rectal bleeding but little of the rectal inflammation that defines UC. Learn More: Mucosal healing in IBS What are some of the complications of inflammatory bowel disease? If left untreated, the persistent inflammation triggered by IBD can affect other organ systems, leading to intestinal and non-intestinal complications. Examples include:Intestines: bowel perforation, toxic megacolonKidneys: kidney stonesLiver: pericholangitisGallbladder: GallstonesJoints: ankylosing spondylitis, sacroiliitis, axial arthritis, peripheral arthritisEyes: episcleritis, scleritis, iritis, uveitisSkin: erythema nodosum, pyoderma gangrenosum Can inflammatory bowel disease lead to cancer? Colorectal cancer is one of the biggest concerns related to ulcerative colitis. Ulcerative colitis increases cancer risk 10- to 30-fold compared to the general population. The risk starts to increase eight to 10 years after the initial diagnosis and continues to increase over time. After 30 years, the risk of colorectal cancer may be as high as 18%. Learn More: Colorectal and colon cancer 11 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Crohn’s & Colitis Foundation of America. The Facts About Inflammatory Bowel Diseases. Klingberg E, Strid H, Ståhl A, et al. A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis. Arthritis Res Ther. 2017;19(1):21. doi:10.1186/s13075-017-1223-2 Schiller LR. Evaluation of chronic diarrhea and irritable bowel syndrome with diarrhea in adults in the era of precision medicine. Am J Gastroenterol. 2018;113(5):660-669. doi:10.1038/s41395-018-0032-9 Crohn's & Colitis Foundation. Malnutrition and IBD. Crohn's and Colitis Canada. Living with Crohn's & Colitis. Crohn's & Colitis Foundation. Fact Sheet: News from the IBD Help Center: Intestinal Complications. Lewis SL, Bucher LB, Heitkemper MM, Harding MM, Kwong J, Roberts D. Medical-Surgical Nursing: Assessment and Management of Clinical Problems. Oxford, UK: Elsevier Health Sciences. Zhou N, Chen W, Chen S, Xu C, Li Y. Inflammatory bowel disease unclassified. J Zhejiang Univ Sci B. 2011;12(4):280-6. doi:10.1631/jzus.B1000172 McDowell C, Farooq U, Haseeb M. Inflammatory bowel disease. In: StatPearls [Internet], Tremaine WJ. Diagnosis and treatment of indeterminate colitis. Gastroenterol Hepatol (N Y). Yashiro M. Ulcerative colitis-associated colorectal cancer. WJG. 2014;20(44):16389. doi:10.3748/wjg.v20.i44.16389 By Amber J. Tresca Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Cookies Settings Accept All Cookies