What is Ulcerative Colitis?

Ulcerative colitis is a chronic disease that causes inflammation and sores (ulcers) in the lining of the colon (large intestine) and rectum. It is part of a group of conditions known as inflammatory bowel diseases (IBD). Treatments can help manage symptoms and induce remission.

These include medications to reduce inflammation and suppress the immune system, dietary changes, and sometimes surgery to remove the affected parts of the colon. Regular medical care is essential for managing the disease effectively.

What are the 4 Stages of Ulcerative Colitis?  

It progresses through four stages, each with distinct symptoms and severity:

1. Mild Stage

In the mild stage, symptoms are relatively minimal. Individuals may experience:

• Mild abdominal pain or discomfort
• Intermittent diarrhea, sometimes with small amounts of blood
• Occasional urgency to have a bowel movement
• Mild fatigue

At this stage, the inflammation is usually confined to the rectum and the lower part of the colon. The symptoms may be sporadic, and periods of remission (times when symptoms disappear) are common.

2. Moderate Stage

As the disease progresses to the moderate stage, the symptoms become more noticeable and frequent. These can include:

• Increased abdominal pain and cramping
• Frequent diarrhea with noticeable blood and mucus
• Urgency to defecate, often with little warning
• Moderate fatigue
• Weight loss

Inflammation spreads further into the colon, leading to more significant discomfort and disruption of daily life. Patients may begin to see their quality of life affected by the symptoms.

3. Severe Stage

In the severe stage, the symptoms are intense and persistent. These include:

• Severe abdominal pain and tenderness
• Constant diarrhea, often bloody, sometimes exceeding six bowel movements per day
• Severe urgency to defecate
• Significant weight loss and malnutrition
• High levels of fatigue and weakness
• Fever

Inflammation covers extensive portions of the colon, and complications such as anemia (due to blood loss) and dehydration (due to frequent diarrhea) can arise. This stage significantly impacts the patient’s daily activities and overall well-being.

4. Fulminant Stage

The fulminant stage is the most critical and potentially life-threatening. Symptoms include:

• Excruciating abdominal pain
• Continuous, bloody diarrhea (more than ten bowel movements per day)
• Severe dehydration
• Rapid weight loss and severe malnutrition
• Fever and other signs of infection
• Risk of colon rupture or toxic megacolon (a dangerous widening of the colon)

This stage requires immediate medical attention and often hospitalization.

Dr. Kailash Mishra
Director & Gastroenterologist Consultant
Prime Gastro Liver Clinic