What to Expect If You Have Ulcerative Colitis

With ulcerative colitis, you probably look forward to the times when it’s under control. And with good medical care and some TLC for yourself, those times can last months, or even years.

Maybe your case is mild. Or it could feel really bad right now. And that can change over time. Even during good periods, it can flare up.

You’ll want to know what could happen and how to handle it.

How You May Feel

Ulcerative colitis attacks the lining of your digestive tract. It causes swelling and sores in the lining. 

If you’ve just been diagnosed with it, here’s what might happen during a flare-up:

  • Persistent diarrhea
  • Belly pain and cramps
  • Blood in your stool
  • Frequent bowel movements
  • Loss of appetite
  • Weight loss
  • Fatigue

You might have some of those symptoms, but not all. And they may change over time. They can range from very mild to very bad.  

Classifying Ulcerative Colitis

Clinical remission. This means you don’t have any major problems or discomfort. If you have about three solid bowel movements a day and up to one watery stool a day, you’re probably in clinical remission.  

Mild to moderate. The disease tends to start slowly, but gets worse over time. (Most people develop only a mild to moderate case.) 

Severe. If you have six or more bloody stools a day, your ulcerative colitis is probably severe. You may also have other symptoms like a faster heart rate or fever.

Toxic. This word describes a critical form of severe colitis. If you have 10 or more bowel movements a day, along with rectal bleeding, fever, and other symptoms, you have toxic colitis. You need to go to the hospital.


If you keep up with your treatment, you lessen the chance of serious complications. But you’ll still want to know what to watch for.

An intestinal hole or tear can happen because of inflammation of parts of the colon. The swelling can cause your intestinal walls to weaken over time and allow a hole or tear to form. If this happens, immediate surgery is needed to repair it.


Toxic megacolon is a rare complication of UC. When inflammation spreads into the deep tissue layers of the large intestine, or colon, your colon can swell and stop working. If this happens, you may need surgery.

Heavy bleeding, or a hemorrhage, may mean you need a blood transfusion. If you’re bleeding heavily from a UC complication, it’s called a hemorrhage. It means you may be losing a life-threatening amount of blood. It’s rare, but can happen.

If and when you ever need surgery for UC, your doctor will talk with you about the options, what’s involved, and what results you can expect.  

WebMD Medical Reference Reviewed by Minesh Khatri, MD on August 14, 2018



Crohn’s & Colitis Foundation of America: “What is Ulcerative Colitis?”

Cleveland Clinic: “Inflammatory Bowel Disease.”

Strong, S. Clinics in Colon and Rectal Surgery, published online Dec. 7, 2010.

Mayo Clinic: Ulcerative Colitis.”

© 2018 WebMD, LLC. All rights reserved.