Newly Diagnosed with Ulcerative Colitis?

Medically Reviewed by Minesh Khatri, MD on February 19, 2024
Written by WebMD Editorial Contributors
4 min read

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.

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.

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.

It can be hard to navigate daily life with symptoms of ulcerative colitis. You might feel exhausted and overwhelmed, especially at first. But you can come up with positive strategies to help you cope.

First, consider sharing your health issues with those closest to you. This will help them understand your needs, especially when you’re having a flare-up that can limit what you’re willing or able to do.

It also helps to plan ahead. Just knowing what to expect in a particular social situation can help cut down on anxiety. If you’re going to be out in public, make sure you know where the bathrooms are. If you’re going to a restaurant, look ahead of time at the menu to find something that’s less likely to cause or worsen your symptoms.

There also are things you can do on a daily basis to take care of your mental health.

  • Schedule rest time. Rest is one key to mental focus and a stable mood. It’s easier to stay focused if you know you have a rest scheduled into your day.
  • If you know you need time for medical care, schedule that in as well.
  • Prepare for your days the night before: A simple to-do list might lessen stress that can inflame UC. You might even lay out an outfit or pack a UC-friendly lunch.
  • Plan little things to look forward to: A morning reading ritual, a lunchtime walk, your favorite TV show, a favorite breakfast meal.
  • Try to do regular exercise, which has been shown to help maintain a positive mood and lessen the stress that can worsen UC symptoms.
  • Consider meditative activities like yoga, breathing exercises, and biofeedback, which may also lessen stress.

You’re more likely to be depressed if you have ulcerative colitis, compared to the general population and even to people with other diseases. Anxiety is also common. If you’re still struggling with daily life and work several weeks after your diagnosis, it may be time to reach out for mental health counseling. Online resources can help you find a therapist, some of whom specialize in people who have gastrointestinal issues. Talk to your medical care team for more guidance.

There are also a number of support communities. (Find one in your area or online at www.crohnscolitisfoundation.org/find-a-support-group.)

Call the Suicide Hotline at 988 or dial 911 if you have persistent thoughts of harming yourself or taking your life. You can also go to the nearest emergency room.