What Does Poop Look Like During an Ulcerative Colitis Flare?

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

One of the most common signs of UC recurrence is diarrhea or loose stools, Moss said. Stool can be mushy or completely liquid without forming, and often falls into types 5 to 7 on the Bristol Stool Chart, he says.

“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

Fresh blood in the stool, or bloody stool, is a symptom of active ulcerative colitis and shouldn’t be ignored, says Supriya Rao, M.D., a gastroenterologist and spokesperson for the American College of Gastroenterology in Lowell, Massachusetts.

“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.

See also 5 Foods to Avoid During Menopause
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

Tenesmus is the pain that makes you want to go to the toilet even though you are unable to do so or have little or nothing to excrete. As many as 30% of people with IBD experience tenesmus, which is a warning sign of chronic inflammation in the lower intestine.

“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

Some people may also experience non-intestinal symptoms, such as joint pain, skin rash, and eye irritation.