Ulcerative colitis is a chronic condition that develops over several stages, including mild, moderate, and severe.

Ulcerative colitis (UC) is a
The condition causes inflammation and deterioration of the colonic wall, resulting in bloody diarrhea, which may also occur with mucus. The severity of the symptoms depends on whether a person’s condition is at a mild, moderate, or severe stage.
This article looks at the stages of UC, its symptoms, complications, treatments, and frequently asked questions.
There are three main stages to UC. The classification
- mild — fewer than four episodes per day
- moderate — more than four episodes per day
- severe — more than
six episodes per day
A fourth category is fulminant UC, a subset of the disease that
- frequent bloody stools
- weight loss
- high fever
- abdominal tenderness
These symptoms, without treatment, may result in hospitalization.
Specific symptom progression
Most rectal symptoms develop within the
With severe UC, there may also be features suggesting the condition affects other areas of the body. At this point, the person may also be showing signs of hypoalbuminemia, where there is insufficient albumin protein in the blood.
Symptoms of UC increase in severity with each stage of the disease. Symptoms that increase as the disease progresses can include the
- tenesmus, which causes the urge to pass stool despite not needing to
- malaise, a general feeling of discomfort, illness, or fatigue
- weight loss
- fever
In severe cases, UC can cause symptoms in parts of the body outside the intestines, called extraintestinal manifestations. These symptoms can
- eye conditions, such as:
- episcleritis
- scleritis
- uveitis
- peripheral arthropathies
- erythema nodosum, a condition that causes painful bumps under the skin on a person’s shins
- pyoderma gangrenosum, a type of skin disorder
UC is a chronic condition that can cause complications throughout a person’s lifetime as the disease increases and decreases in severity.
Common symptoms of mild or moderate UC can contribute to malnutrition and weight loss, including:
- Diarrhea: This can cause dehydration, which means the body is low in fluids, nutrients, and necessary electrolytes such as:
- Abdominal pain and nausea: These symptoms can reduce a person’s appetite, making it difficult for someone to consume enough calories and sufficient nutrients.
- Rectal bleeding: This bleeding can lead to iron deficiency anemia.
- Frequent bowel movements: These movements may cause a person to eat less to avoid diarrhea, putting a person at risk of becoming malnourished.
More severe complications that can occur throughout the stages of UC, but particularly at later stages,
- anastomotic leak
- pelvic abscess
- enterocutaneous fistulas, which create atypical openings, causing leaks
- incontinence
- sexual dysfunction
- toxic megacolon
- colorectal cancer
While there is no cure for UC, there are treatments available.
Some treatments
- oral aminosalicylates, such as mesalamine or sulfasalazine
- topical aminosalicylates
- corticosteroids
- immunomodulators
- antimetabolites
Learn more about UC-approved drugs.
The following table shows
Stage | Treatment |
mild | oral aminosalicylates, or 5-ASA enema with 5-ASA |
moderate | oral 5-ASA enema with 5-ASA oral glucocorticoids enema with glucocorticoids |
severe | oral 5-ASA enema with 5-ASA oral or IV glucocorticoids enema with glucocorticoids |
fulminant | IV glucocorticoids IV cyclosporine |
Below are some frequently asked questions on UC.
How fast does UC progress?
UC
How long do symptoms of UC typically last?
The duration of UC exacerbations varies from days to months.
How do doctors determine the stage or severity of UC?
Doctors grade the
What is the most common age to receive a diagnosis of UC?
There are two peak ages when UC may develop. The
How do flares of UC vary between mild, moderate, and severe cases?
UC symptom exacerbations typically worsen with each stage, with severe cases causing the most significant symptoms and complications.
UC is a chronic condition that may have periods of flares and remissions. The main indications of UC are bloody diarrhea and abdominal pain.
There are different criteria that a doctor may use to identify the stage of UC. However, the stage usually depends on how many bleeding episodes a person has in a day.
The main stages of UC are mild, moderate, severe, and fulminant. Fulminant UC is a subset of the condition that causes sudden and severe symptoms.
UC is not curable with medication, but treatments can reduce the frequency and severity of flares specific to the stage.