Ulcerative Colitis Symptoms & How They Differ From Crohn’s Disease
Emer O'Driscoll
Video
11 min
In this video, we cover common ulcerative colitis symptoms and how they differ from Crohn’s disease. It explains how inflammation affects the digestive system, fertility and why diet and lifestyle adjustments matter during flare-ups.
Ulcerative colitis is a chronic inflammatory bowel disease that affects the digestive system and can influence overall health far beyond the gut. People living with this condition often experience symptoms that interfere with daily routines, work, social life and emotional wellbeing. Because ulcerative colitis shares similarities with Crohn’s disease, the two conditions are frequently confused, which can make it harder to understand symptoms and manage them effectively.
Understanding ulcerative colitis symptoms is essential for recognising the condition early and responding in a way that supports long-term health. While both ulcerative colitis and Crohn’s disease are inflammatory bowel diseases, they differ in how inflammation appears, where it is located and how symptoms develop over time. Inflammation also plays a central role in fertility and reproductive health, making symptom awareness particularly important for individuals or couples trying to conceive.
Quick answer: Ulcerative colitis symptoms commonly include persistent diarrhoea, abdominal pain, cramping, blood or mucus in the stool, fatigue and weight loss. Ulcerative colitis affects only the colon and rectum and causes continuous inflammation, while Crohn’s disease can affect multiple parts of the digestive tract in patches.
What Is Ulcerative Colitis?
Ulcerative colitis is a chronic inflammatory bowel disease that affects the inner lining of the colon and rectum. Inflammation usually begins in the rectum and can spread upward through part or all of the colon. One of the defining features of ulcerative colitis is that inflammation is continuous, meaning there are no healthy sections between inflamed areas.
The colon plays a key role in absorbing water and forming stool. When the lining of the colon becomes inflamed, this process is disrupted, leading to many of the symptoms associated with ulcerative colitis. The condition typically follows a pattern of flare-ups and remission, with periods of increased symptoms followed by times when symptoms ease.
What Is Crohn’s Disease?
Crohn’s disease is another form of inflammatory bowel disease, but it differs from ulcerative colitis in both location and pattern of inflammation. Crohn’s disease can affect any part of the gastrointestinal tract, from the mouth to the anus. It most commonly affects the end of the small intestine and the beginning of the colon.
Unlike ulcerative colitis, inflammation in Crohn’s disease occurs in patches. Healthy areas of the digestive tract may appear between inflamed sections. In addition, inflammation in Crohn’s disease can penetrate deeper into the intestinal wall, which explains why the condition may lead to different symptoms and complications.
Shared Symptoms of Ulcerative Colitis and Crohn’s Disease
Because both conditions involve chronic intestinal inflammation, ulcerative colitis and Crohn’s disease share several common symptoms. These include:
- Persistent diarrhoea
- Abdominal pain and cramping
- Blood or mucus in the stool
- Frequent and loose bowel movements
- Fatigue
- Unintentional weight loss
These symptoms reflect ongoing irritation of the intestinal lining. During periods of active inflammation, digestion becomes less efficient, nutrient absorption may be reduced and bowel movements may become urgent and unpredictable.
Ulcerative Colitis Symptoms in Daily Life
Ulcerative colitis symptoms can vary in severity, but even milder symptoms may significantly affect daily life. Persistent diarrhoea often leads people to plan their day around access to bathrooms, which can limit work schedules, social activities and travel. Abdominal pain and cramping may occur unpredictably, creating discomfort and stress throughout the day.
Blood or mucus in the stool can be distressing and may cause anxiety around bowel habits. Fatigue is also common and may feel disproportionate to activity levels. Over time, these symptoms can affect confidence, mood and overall quality of life, highlighting the importance of symptom awareness and management.
Symptoms More Specific to Ulcerative Colitis
Some symptoms are more specific to ulcerative colitis and help distinguish it from Crohn’s disease. These include:
- Rectal bleeding
- Tenesmus, the sensation of needing to pass stool even when the bowels are empty
These symptoms are closely linked to inflammation in the rectum and lower colon. Tenesmus can be particularly uncomfortable, as it creates a constant urge to use the bathroom even when there is little or no stool present. These features reflect the continuous inflammation that characterises ulcerative colitis.
Symptoms More Common in Crohn’s Disease
Although Crohn’s disease shares many symptoms with ulcerative colitis, it also presents some distinct features. Symptoms more commonly associated with Crohn’s disease include:
- Mouth sores
- Perianal disease, including fistulas and abscesses
These symptoms occur because Crohn’s disease can affect deeper layers of the intestinal wall and areas beyond the colon. Perianal complications are particularly characteristic of Crohn’s disease and help differentiate it from ulcerative colitis.
How Ulcerative Colitis Symptoms Change Between Flare-Ups and Remission
Ulcerative colitis symptoms do not remain constant. The disease typically alternates between flare-ups and remission, and symptoms can feel very different during each phase. During flare-ups, inflammation is more active, which often leads to frequent bowel movements, increased urgency, abdominal pain and greater fatigue.
During remission, inflammation is reduced and symptoms often ease. Some people experience fewer bowel movements, less pain and improved energy levels. However, remission does not always mean symptoms disappear completely. Mild digestive sensitivity or fatigue may persist, reminding individuals that ongoing awareness and management remain important.
Why Inflammation Is Central to Ulcerative Colitis Symptoms
Inflammation is the underlying driver of ulcerative colitis symptoms. Chronic inflammation disrupts the normal function of the digestive system and places stress on the body as a whole. Over time, this inflammatory state can influence immune function, energy levels and hormone balance.
This systemic impact helps explain why ulcerative colitis can affect areas beyond digestion, including fertility and reproductive health. Managing inflammation is therefore central to reducing symptoms and supporting overall wellbeing.
How Ulcerative Colitis and Crohn’s Disease Affect Fertility
Inflammatory bowel diseases can affect fertility in several interconnected ways. Chronic inflammation may disrupt hormonal balance, ovulation and the quality of eggs and sperm. It can also impair implantation of a fertilised egg and influence placental development.
Inflammation in the gut can interfere with the absorption of essential nutrients needed for reproductive health. During prolonged flare-ups, reduced nutrient absorption, decreased appetite and dietary restrictions may further affect fertility.
Psychological stress also plays a role. Managing a chronic condition and coping with ongoing symptoms can increase stress and anxiety, which may influence reproductive function. Certain medications and surgical treatments, particularly those involving the pelvic area, can also affect fertility and should always be discussed with a healthcare professional.
Why Nutrient Absorption Matters in Ulcerative Colitis
Inflammation in the colon can interfere with the body’s ability to absorb nutrients effectively. When nutrient absorption is compromised, energy levels may decline and the body may struggle to support essential processes, including reproductive health.
During flare-ups, frequent bowel movements and digestive discomfort can further limit nutrient availability. Over time, this can contribute to fatigue and weakness. This connection explains why dietary adjustments are often an important part of managing ulcerative colitis symptoms.
Dietary Adjustments During Flare-Ups
Diet plays a significant role in symptom management, particularly during flare-ups. When inflammation is high, the digestive system benefits from foods that are easier to digest while still providing nourishment.
An anti-inflammatory approach is often recommended. Foods mentioned include vegetables, fruits, berries, nuts and seeds, olive oil and fatty fish. To reduce digestive strain, vegetables can be cooked rather than eaten raw, fruits can be peeled and nuts and seeds soaked or blended.
Soups, smoothies, purees and nut butters can help reduce fibre irritation while supporting nutrient intake.
Foods Often Avoided During Flare-Ups
During flare-ups, some people benefit from temporarily excluding certain foods. These may include:
- Grains with or without gluten
- Nightshade vegetables such as tomatoes, bell peppers, potatoes and aubergine
- Legumes containing lectins
- Sugar
- Dairy products, depending on individual tolerance
Fibre intake may also need to be reduced temporarily and reintroduced during remission when tolerated.
Identifying Individual Trigger Foods
Trigger foods vary between individuals. Common triggers mentioned include high-fibre foods, grains, dairy, fructose, sugar, histamine, legumes, spices, caffeine, alcohol and nicotine.
Keeping meals simple during flare-ups can help identify triggers more easily. Limiting the number of ingredients in a meal makes it easier to observe how specific foods affect symptoms while still allowing for nutritional variety across the week.
Food Preparation and Symptom Severity
The way food is prepared can influence how well it is tolerated during periods of active inflammation. Cooking vegetables helps break down fibre, peeling fruits removes tougher skins and soaking nuts and seeds softens their structure.
Blended foods such as soups and smoothies reduce digestive workload while still providing nourishment. These preparation methods do not change what foods are eaten but can significantly affect how the body responds to them.
Lifestyle Adjustments That Support Symptom Management
Lifestyle factors play an important role in managing ulcerative colitis symptoms. Stress management is particularly important, as stress can directly affect digestion and symptom severity. Practices such as breathing exercises, gentle movement and relaxation techniques can help reduce stress.
Physical activity supports digestion and overall wellbeing, but intensity should be adjusted during flare-ups. Low-intensity activities such as walking or cycling may be better tolerated when symptoms are active.
Sleep, Recovery and Energy Levels
Sleep is essential for healing and immune regulation. Poor sleep can worsen fatigue and may intensify symptom perception. Aiming for eight to ten hours of quality sleep supports recovery, reduces stress on the body and helps manage inflammation more effectively.
When Ulcerative Colitis Symptoms Resemble Crohn’s Disease
Because ulcerative colitis and Crohn’s disease share many symptoms, early experiences may feel similar. Diarrhoea, abdominal pain and fatigue can occur in both conditions. Differences often become clearer over time as inflammation patterns, symptom location and disease behaviour are identified.
Understanding these overlaps highlights the importance of careful diagnosis and ongoing monitoring.
Conclusion
Ulcerative colitis symptoms can significantly affect daily life, but understanding how the condition differs from Crohn’s disease provides clarity and direction. Ulcerative colitis affects the colon and rectum with continuous inflammation, while Crohn’s disease can affect multiple parts of the digestive tract in patches and penetrate deeper into the intestinal wall.
Recognising symptoms, understanding the role of inflammation and making informed dietary and lifestyle adjustments can help manage flare-ups and support long-term health. Awareness of how inflammatory bowel disease influences fertility further emphasises the importance of comprehensive symptom management. With informed choices and ongoing care, individuals can better navigate ulcerative colitis and improve overall wellbeing.
