Call a doctor immediately if you have been diagnosed with ulcerative colitis and you have any of the following:

• Fever over 101F or shaking chills
• Lightheadedness, passing out, or rapid heart rate
• Stools that are almost always bloody
• Severe dehydration
• Severe abdominal pain with or without bloating
• Pus draining from the area around the anus or pain and swelling in the anal area
• Repeated vomiting
• Not passing any stools or gas

If you have any of these symptoms and you have been diagnosed with ulcerative colitis, your disease may have gotten significantly worse. Some of these symptoms also may be signs of toxic megacolon, a condition in which the colon swells to many times its normal size. Toxic megacolon requires emergency treatment. Untreated toxic megacolon can cause the colon to leak or rupture, which can be fatal.

People who have ulcerative colitis usually know their normal pattern of symptoms. Call your doctor if there is a change in your usual symptoms or if:

• Your symptoms become significantly worse than usual.
• You have persistent diarrhea for more than 2 weeks.
• You have lost weight.

Watchful Waiting

Watchful waiting is not appropriate when you have any of the above symptoms. If your symptoms are caused by ulcerative colitis, delaying the diagnosis and treatment may make the disease worse and increase your risk of complications.

Even when the disease is in remission, your doctor will want to see you regularly to check for complications, some of which can be hard to detect. It is always appropriate to call your doctor's office for advice.

Who To See

Health professionals who can diagnose ulcerative colitis include:

• Family medicine doctor.
• Internist.
• Gastroenterologist.

For the treatment and management of ulcerative colitis, you are likely to be referred to a gastroenterologist.

To be evaluated for surgery, you may be referred to a:

• General surgeon.
• Colon and rectal surgeon.

To prepare for your appointment, see the topic Making the Most of Your Appointment