Fiducia TogetherUlcerative colitis
Inflammation of the large bowel lining. One of the two main forms of inflammatory bowel disease, and it has its own emergency.
Important: This page is general information, not medical advice, and it is not a diagnosis. If you are worried about your health or someone else's, speak to a GP, pharmacist, or call 111. In an emergency, call 999.
What it is
Ulcerative colitis inflames and ulcerates the lining of the large bowel, always starting at the rectum and extending upward by a variable amount. It is one of the two main forms of inflammatory bowel disease.
Around 1 in 250 people in the UK have it. It relapses and remits, and it is not caused by diet or stress, though both affect how somebody copes.
It has one specific emergency worth knowing: acute severe colitis, where the bowel becomes dangerously inflamed. It needs hospital admission, and delay leads to perforation and to emergency surgery.
Signs you might notice
Diarrhoea with blood and mucus, often many times a day.
Urgency, and the need to open bowels at night.
Cramping abdominal pain, relieved by opening bowels.
Tiredness, weight loss, fever in a flare.
Acute severe colitis: more than six bloody stools a day with fever, a fast heart rate, anaemia or feeling very unwell. That combination is an emergency.
How it can affect day-to-day life
Urgency governs everything. People plan around toilets, and an accident in public is a genuinely traumatic event that reshapes behaviour for months.
Steroids relieve flares and are not a long-term answer. Repeated courses signal that maintenance treatment needs escalating.
Around one in five people eventually need surgery to remove the colon, which for many is a substantial improvement rather than a failure, and it deserves being framed that way.
Bowel cancer risk rises with extent and duration of disease, which is why surveillance colonoscopy matters.
Supporting someone well
Take the maintenance treatment in remission. Stopping mesalazine when well is a leading cause of relapse, and it also reduces cancer risk.
Have a flare plan and a named IBD nurse, so a flare is treated in days rather than after a routine appointment.
Recognise acute severe colitis and go to hospital. Do not sit at home on steroids getting worse.
Get a Can't Wait card and a RADAR key, and make toilet access explicit in writing at school or work.
Keep up the surveillance colonoscopies.
Check iron, B12 and vitamin D, and treat fatigue as a symptom to investigate.
Where to get help
A gastroenterologist and IBD nurse manage this. Ask for direct access to the nurse for flares.
Crohn's and Colitis UK run a helpline and produce the Can't Wait card.
Heavy bleeding, severe pain with a swollen abdomen, or fever with frequent bloody stools needs emergency assessment.
Last reviewed 2026-08-28 by Fiducia Together · Next review due 2027-08-28
Important: This page is general information, not medical advice, and it is not a diagnosis. If you are worried about your health or someone else's, speak to a GP, pharmacist, or call 111. In an emergency, call 999.