Monitoring your gut health and stool is important for everyone, but it’s even more important for people with ulcerative colitis, says Alan Moss, MD, chief scientific officer of the Crohn’s and Colitis Foundation and professor of gastroenterology at Boston University Chobanian-Avedisyan School of Medicine.
“For people with ulcerative colitis, paying close attention to stool patterns such as frequency, consistency, blood volume, urgency, and nighttime symptoms, and sharing those details with your gastroenterology team early on, is one of the most powerful ways to prevent flare-ups,” says Dr. Moss.
Please contact the IBD team if you experience any of the following changes: “Visible bleeding, persistent diarrhea, or a major change from ‘usual’ are not trivial enough to mention,” he says.
consistency
“During a UC flare-up, bowel movements are usually loose or watery and occur with more strain than usual,” he says, noting that this is not a one-time episode and can occur multiple times a day. Stomach cramps are often accompanied by changes in stool, which is a “strong signal” to contact your gastrointestinal team.
blood
“With UC, there is no amount of blood that is considered normal, even if it’s just on toilet paper,” Dr. Rao says. She said:
- Bright red blood usually indicates active inflammation in the rectum or lower colon, while darker blood (from the top) can indicate more extensive disease.
- Blood may be mixed throughout the stool, coating it, or it may only be on the toilet paper after it has been wiped. In any case, you should consult your doctor, especially if symptoms persist or increase, as even small amounts may indicate active disease.
Heavy bleeding, blood clots, or dark maroon stools may indicate more extensive bleeding and require urgent medical attention, Moss says.
mucus and pus
The colon produces mucus to protect the mucous membranes, but when inflammation occurs, excess mucus can be produced. In people with ulcerative colitis, this excess mucus may appear as clear, white, or yellowish jelly-like lumps in the toilet and on the stool.
Yellow or green mucus or pus in the stool can also indicate an infection, Rao says.
Tenesmus
“Tenemus usually means the disease is completely out of control,” Rao says.
Other red flags to look out for
Other important warning signs, according to Moss, include:
- Increased urgency or sudden need to find a restroom
- Having a bowel movement at night or waking up in the middle of the night to have a bowel movement
- Changes in odor, such as foul-smelling stools, may indicate malabsorption or an infection caused by bacteria. clostridioides difficile
- Abdominal pain or sudden cramps
- rectal pain
- Fatigue and fever (including slight fever)
- weight loss and loss of appetite
