Why UC Can Vary From Person to Person

Medically Reviewed by Minesh Khatri, MD on March 25, 2023
5 min read

Ulcerative colitis (UC) could look and feel a lot different for you than it does for someone else with the disease. Things like the symptoms you get, how severe they are, and how much they impact your life can vary from one person to another. Here’s a look at why no two experiences with UC are exactly the same.

When you have ulcerative colitis, the lining of your large intestine becomes inflamed and gets sores called ulcers. The symptoms that follow depend on how bad the inflammation is and how much of your large intestine it affects. Your doctor does tests to find these things out, and they use that info to make a treatment plan for you.

They may tell you that your ulcerative colitis is mild, moderate, or severe, depending on your symptoms.

In general, mild UC may bring on:

Moderate UC may cause:

  • Bloody diarrhea four or more times a day
  • Tiredness or weakness
  • Mild to moderate belly pain
  • Low fever

Severe UC may bring on:

  • Bloody diarrhea six or more times a day
  • Tired or weak feeling
  • Serious belly pain and cramping
  • Fast heartbeat
  • Fever
  • Unhealthy weight loss that can happen fast

Experts aren’t sure why, but some people get symptoms outside of their large intestine. It’s possible to have:

  • Red rashes on your skin
  • Pain or swelling in your joints
  • Sores called ulcers in your mouth
  • Redness and irritation in your eyes

Your symptoms can change over time, too. Let your doctor know if this happens.

UC symptoms tend to come and go. When treatment gets them under control and you feel good, that’s called remission. When your symptoms come back, it’s called a flare-up. Talk to your doctor right away so you can get them under control as soon as possible.

Ulcerative colitis can be unpredictable. Some people get better after one bout of symptoms and stay in remission for years. Other people with severe UC need to go to the hospital often, sometimes for surgery to treat it.

Even though there’s no telling how often you’ll have a flare, some things might lead to one or make it worse:


Certain things you eat or drink could make your symptoms worse during a flare. There’s no single food or drink that’s a trigger for everybody with UC, though.

Keep a list of the ones that seem to give you trouble. Then share this “food journal” with your doctor or a dietitian. They can help you figure out which foods to avoid and suggest diet changes for you.

They may recommend certain eating plans at different times, depending on things like the symptoms you have and the type of UC medication you take. It’s important to get diet advice that’s tailored just for you, since there isn’t an “ulcerative colitis diet” that helps everyone all of the time.

In general, eat a balanced diet and ask your doctor or dietitian if you should take any nutritional supplements.

Over time, UC can lead to other problems that your doctor needs to treat. Not everyone gets these. But they tend to happen more often in people who don’t stick to their treatment plan.

Some complications of UC are:

Anemia. This condition can make you tired and weak, because you’re low on red blood cells. Bleeding ulcers in the lining of your large intestine can cause it -- the blood flows out of your colon and leaves your body through your anus. (Severe bleeding is rare, though.)

Dehydration. One of your large intestine’s jobs is to absorb water from partially digested food. Inflammation and severe diarrhea from UC can keep it from doing this well enough and leave you dangerously dehydrated.

Weakened bones. You may have low bone mass due to a condition called osteopenia or a more serious form of it called osteoporosis. These can stem from UC and steroid treatments for it.

A hole in the colon. Your doctor may call this a “bowel perforation.” It can cause a bacterial infection that can be life-threatening.

Extremely severe UC. Your doctor may call this “fulminant ulcerative colitis,” and it can bring on extra-severe symptoms like having bloody diarrhea more than 10 times a day. Less than 10% of people with UC get this complication.

Large intestine stops working. This can happen if inflammation spreads into the organ’s deep layers and makes it swell. Your doctor may call this complication “toxic megacolon.” It’s rare, but it can be deadly without surgery.

Colorectal cancer. Around 5% to 8% of people with ulcerative colitis get this type of cancer within 20 years of being diagnosed with UC. Screening tests can help your doctor spot it early.

Living with an inflammatory bowel disease like ulcerative colitis poses different challenges for different people. The stress of having a long-term condition can affect your mental health, relationships, job, and finances. Exactly how much or how little it impacts each person’s daily life varies, depending on things like how severe the disease is and what they do to manage it.

Wherever you’re at in your journey with UC, it’s important to take charge of any physical, mental, and emotional challenges that come up. Reach out to your doctor and loved ones for help when you need it. Consider joining an online or in-person support group, too.