Signals of Ulcerative Colitis Flare-up

Signs of a Flare-up

I often see UCers and IBDers asking how they'll know if a flare-up is about to start. The different causes are often discussed, but symptoms that signal the start of a flare are often missed, which for some can result in a longer or more severe flare-up.

Can you feel it?

I'll repeat the UC mantra at the start of this page - Ulcerative Colitis is very individual, so signals will differ greatly. The key to discovering signals to a flare-up is to pay attention when in remission - a diary is a great way to do this. Note down everything that feels slightly different, however minor.

Outside of the main Colitis symptoms, feelings can be notoriously difficult to explain, especially if they're quite subtle, which often happens before a flare kicks in.

So as I said, can you feel it? Well if you can, it could well be a sign of inflammation. I often see UCers mention things such as; a weird feeling down the left side of the diaphragm; a feeling of needing a bowel movement; twinges in the sphincter (surely an excellent title for a book ); occasional pains in the rectum, an uneasy feeling in the transverse colon (often mistaken for the stomach) etc. The variations are endless, but would suggest a similar cause - inflammation.

To put it another way, apart from a normal urge to go to toilet two or three times a day, with a healthy colon you shouldn't and wouldn't normally feel anything along the colon to do with bowel movements. Therefore, outside of natural urges, I would begin to suspect that inflammation is the reason I'm starting to feel things happening - wherever it is along the colon.

It's not all about the colon!

Some UCers find they experience symptoms in a similar place each time before flare-ups begin, these can occur in various areas of the body depending on the sufferer.

So for example, I've seen some UCers mention mouth ulcers whilst others experience various aches (often in the joints) - both signs of inflammation. My theory is that for Ulcerative Colitis sufferers, anything out of the ordinary should be treated with suspicion

Seemingly innocent and subtle changes can be a sign that the immune system is fighting a virus. If my sleep pattern changes and I'm unable to sleep properly, or I keep waking up during the night, I am suspicious - in the past it has meant the start of a virus such as a cold. For some UCers a cold can lead into a flare-up, so jumping on it as soon as possible may just prevent it from developing into something worse.

List of signals to a flare-up

So, here's a list of various symptoms I've seen UCers mention when they were about to start a flare-up; sometimes one symptom, sometimes a few ...and in no particular order:

  • Bloating
  • Mouth ulcers
  • Itchy skin
  • Blood in the stool
  • Slight urgency
  • Feeling rundown
  • Feeling tired
  • Strange taste in the mouth
  • Joint aches
  • Soft / wet stool
  • Aches / pains along the colon
  • Constipation
  • Mucus in the stool
  • Pain in the rectum / sphincter

It's easy to become paranoid when there are so many potential symptoms, but I would advise UCers to stay aware and keep an eye on anything that persists. If you experience a couple of symptoms it would make sense to treat it as a flare and jump on it as quick as possible.

Always worth having extra meds ready for this (some meds take a while to start working). If changing diet, it can take 3 days to go through the digestive system so it's important to think ahead.

...and so it begins

Of course we don't always notice subtle clues that a flare-up is on it's way, but we should be watching out for 'classic' signals at all times. Unlike the reasons mentioned above, these signals should be treated as conclusive proof that a flare is starting

I've read many times that flare-ups often start from the rectum and spread further along the large colon; an indication that a flare is starting could be symptoms linked with this area e.g. bright coloured blood, slight urgency, a pain in the rectum.

I keep a constant watch out for any feelings out of the ordinary and of course, symptoms that I link to Colitis. Stay vigilant! For example, a spec of blood or some bits of mucus on the stool should be noted, and at the very least, keep an eye out for more symptoms over the next few bowel movements.