10 Stool Changes to Look Out for With Ulcerative Colitis

Ulcerative colitis (UC) can cause inflammation in the lining of your colon and rectum. 

At first, you may go more often. You can get diarrhea with or without blood. Later on, more serious changes include:

• Going more often

• Blood, mucus, or pus in your stools

• Loose or watery stools

• More urgent need to go

• Tenesmus (sudden urge to go without much stool)
   

Keep track of the number, texture, and look of your stools. It can help you see and avoid triggers for flare-ups.

Diarrhea is common with ulcerative colitis (UC). You may notice this symptom first.

Early-stage diarrhea: 

• Mild loose or watery, with or without blood
• Four or fewer daily episodes

For moderate to serious UC, you may get:

•  Four or more daily diarrhea episodes

Serious UC symptoms include: 

• Frequent, heavy diarrhea lasting longer than usual
• Serious diarrhea that worsens

If your stools don't stop or get better, talk to your doctor.

Constipation isn’t as common for UC, but it still happens.

It's harder to go to the bathroom. Your stools may be: 

• Less than three each week
• Hard, dry, or chunky 
• Very big or small 

Inflammation in your rectum (proctitis) can cause constipation — even if symptoms are under control. 

Raise your knees above your hips when you use the toilet. A footstool can help. Try to eat a balanced diet with fiber. And stay hydrated to help your bowels move easier.

More bowel movements (BMs) are a common for ulcerative colitis. During the early stages, you may have bowel movements up to four times a day. 

Once your UC gets moderate to serious, you may need to go more than four times a day. This may also be a sign of a UC flare-up. It can become worse, too. 

If you're having more trips to the bathroom, tell your doctor. Let them know you've noticed more bathroom trips or that it lasts longer.

Unplanned UC bowel movements are common. Here’s some tips for sudden stool leaks:

Control inflammation. Enjoy activities or hobbies to lower stress. Stress doesn’t cause UC but can worsen flare-ups.

Adjust your diet. Avoid triggering foods or drinks. Skip dairy and fiber if they cause problems. Stay away from nuts, popcorn, and alcohol, too.

Plan for toilet access. Quick toilet access can lower stress. It helps manage your bowel incontinence, too.

Tenesmus is when you constantly feel like you need to use the bathroom. But you usually can’t pass stool. It can cause discomfort like pain, cramping, pressure, and straining. 

Tenesmus can often happen with UC. In fact, 30 out of 100 people with UC get tenesmus. It’s usually because of ongoing inflammation in your lower bowel.

If you get tenesmus, fever, nausea, or blood in your stool, get medical help right away.

Painful BMs can cause pain and discomfort. You may notice:

• Stomach cramps

• Frequent urges — sudden need to go, even if you can’t

• Rectal bleeding

• Inflammation

• Irritation

• More painful BMs

Track when your cramps and pain occur and how serious they are. Stay hydrated to ease cramps. Tell your doctor if your pain gets serious or happens more often. They can suggest ways to help relieve your discomfort.

Your UC stool color can give you key insights like:

Red or maroon. Red-colored stools can mean blood in your colon or rectum.
Black or tar-like. Dark stools can mean blood higher up in your digestive tract — your stomach or small intestine.
Whitish, slimy, mucus-like. You can have too much mucus in your intestines.

If your stool changes, talk to your doctor about any new symptoms. If you have black or bloody stools, get medical help sooner.

To protect it, your body normally coats your intestines with mucus. It helps move your stool through, too. 

But inflammation and ulcers can trigger more mucus than usual. You may notice whitish, jelly-like UC mucus in your stool.

If you get a serious UC flare-up, mucus with blood or pus can show up in your stool. Tell your doctor and discuss your symptoms. They’ll help you identify triggers to avoid.

Bloody stool is a key UC symptom. Tell your doctor:

• The number of bloody stools
• The color of the blood (bright or dark)
• Any new symptoms

Blood in your rectum or large intestine can be bright red. Blood in your upper digestive tract can be darker.

Get medical help if your stool: 

• Leaks blood from your rectum
• Has blood clots

Get medical help right away if you: 

• Feel weak or faint
• Vomit blood

Your doctor can suggest the best medication for your bleeding.

Strong or unpleasant UC stool odors are common. Here’s why your stool can smell: 

• Blood can smell like metal.

• Infection can smell “rotten.” 

• Unabsorbed nutrients can ferment in your gut, causing a funky smell.

• Extra mucus in your stool can smell strong or foul.

• Extra mucus buildup can smell strong or foul.

If you notice changes in your stool or feel worse overall, tell your doctor. Tell them about any other symptoms, too.

Some treatments include:

Diet tips 

Identify and avoid triggers like processed, sugary, or fatty foods.

Medications

You may get:

• Diphenoxylate (Lomotil)
• Loperamide (Imodium)
• Mesalamine (Asacol)
• Prednisone (Deltasone)

If symptoms don't improve or they worsen, your doctor can suggest other options.

Retrain and exercise bowels

Make time to fully empty your bowels. Pelvic floor exercises help bowel control so you can live fully with UC.