Medical history and physical exam for ulcerative colitis

A medical history and physical exam are standard tests for people who have abdominal pain and a change in bowel habits. They allow a health professional to determine the seriousness and extent of disease.

The medical history for ulcerative colitis includes questions about:

• Bowel function, including how many bowel movements you have per day or per week, whether you have constipation or diarrhea, whether you have noticed any blood or mucus in your stool, and any recent changes in your bowel habits or the shape of your stools.
• Whether your bowel movement patterns have any relationship to your abdominal pain (for example, if passing a stool relieves your pain).
• Whether your family has any history of similar symptoms.
• Your use of laxatives or medications.
• Factors that may increase your risk of an intestinal infection, such as traveling in a foreign country, drinking untreated water (such as on a hiking or backpacking trip), or recently using antibiotics.
• Your sexual history. Some sexually transmitted diseases may infect the rectum and cause symptoms similar to those of ulcerative colitis.
• Other body systems and whether you have symptoms such as joint pain, eye problems, or a skin rash.

Your health professional will do a standard physical exam, which may include:

• Feeling the abdomen.
• Performing a digital rectal exam.
• Listening for bowel sounds with a stethoscope.
• Examining the eyes, skin, joints, and inside of the mouth.
• Performing a pelvic exam for women.

Ulcerative colitis cannot be diagnosed based on the medical history or physical findings alone. The diagnosis may be suggested if:

• The abdomen is tender.
• You have had blood or mucus in your stools or if the doctor finds signs of blood or mucus during the digital rectal exam. However, mucus by itself can be normal.
• You report frequent episodes of diarrhea, sometimes with blood. You may be awakened at night by an urgent need to have a bowel movement.
• You appear feverish and pale or look underweight. Children may be small or underdeveloped for their age.
• You have a family history of ulcerative colitis, especially in the immediate family.