Can ulcerative colitis symptoms worsen suddenly?

Can Ulcerative Colitis Symptoms Worsen Suddenly?

Yes, ulcerative colitis symptoms can worsen suddenly, even in people who have been stable for months or years. These sudden changes are often called flares. Understanding why flares happen, what they feel like, and when to seek medical help can make ulcerative colitis easier to manage and less frightening.

Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that affects the lining of the large intestine (colon) and rectum. Symptoms tend to come and go over time, with periods of remission followed by periods of active inflammation. While some flares build slowly, others can appear quickly and feel intense.

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What Does a Sudden Worsening of Ulcerative Colitis Look Like?

A sudden flare of ulcerative colitis may involve a noticeable increase in symptoms over days or even hours. Common changes include:

• More frequent bowel movements
• Urgent need to use the bathroom
• Diarrhea that may contain blood or mucus
• Increased abdominal cramping or pain
• Fatigue or low energy
• Loss of appetite
• Unintended weight loss

Some people also notice symptoms outside the gut, such as joint pain, skin rashes, or eye irritation. These can sometimes flare at the same time as bowel symptoms.

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Why Can Ulcerative Colitis Symptoms Get Worse Suddenly?

Sudden flares are not always predictable, but several well-known factors can trigger a rapid worsening of ulcerative colitis symptoms.

1. Medication Changes or Missed Doses

One of the most common reasons for a sudden flare is stopping or missing medication. Even skipping doses for a short time can allow inflammation to return.

This includes:

• Maintenance medications taken long-term
• Steroids that are tapered too quickly
• Biologic or immune-based therapies that are delayed or stopped

2. Infections

Gastrointestinal infections, such as certain bacterial or viral illnesses, can irritate the colon and trigger inflammation. Even a mild stomach infection can lead to a significant ulcerative colitis flare.

3. Stress and Emotional Strain

Stress does not cause ulcerative colitis, but it can worsen symptoms. Major life stress, poor sleep, or ongoing anxiety may contribute to sudden symptom changes by affecting gut-brain signaling and immune responses.

4. Diet Changes

There is no single ulcerative colitis diet, but certain foods may aggravate symptoms during active disease, including:

• Very high-fiber foods during a flare
• Fatty or fried foods
• Alcohol
• Spicy foods

A sudden change in eating habits can sometimes trigger symptoms.

5. Use of Certain Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may worsen ulcerative colitis symptoms in some people. Antibiotics can also disrupt gut bacteria and occasionally lead to flares.

6. Disease Progression

Over time, ulcerative colitis can change in severity or extent. In some cases, inflammation spreads further in the colon, leading to more intense or sudden symptoms.

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Can Mild Ulcerative Colitis Become Severe Quickly?

Yes, in some cases mild ulcerative colitis can worsen quickly. While many flares are manageable, a small number can become severe and require urgent medical attention.

Signs that symptoms may be becoming more serious include:

• Heavy or ongoing rectal bleeding
• Severe abdominal pain or tenderness
• Fever
• Rapid heart rate
• Feeling lightheaded or faint
• Signs of dehydration

These symptoms should not be ignored.

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When Should You Seek Medical Care?

It is important to speak to a doctor if your ulcerative colitis symptoms worsen, especially if the change is sudden or severe.

Seek medical care promptly if you notice:

• A sharp increase in bowel movements
• Blood in the stool that is new or worsening
• Pain that does not improve
• Fever or signs of infection
• Difficulty staying hydrated

Some complications of ulcerative colitis can be life-threatening if untreated, so timely care matters.

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How Are Sudden Ulcerative Colitis Flares Treated?

Treatment depends on how severe the flare is and where the inflammation is located in the colon. A doctor may recommend:

• Adjusting current medications
• Adding short-term steroids to reduce inflammation
• Using rectal treatments (suppositories or enemas)
• Treating underlying infections
• In more serious cases, hospital care for IV medications and fluids

The goal is to calm inflammation, relieve symptoms, and prevent complications.

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Can Sudden Flares Be Prevented?

While not all flares can be prevented, many people with ulcerative colitis reduce their risk by:

• Taking medications exactly as prescribed
• Attending regular follow-up appointments
• Managing stress and sleep
• Avoiding known food triggers during active disease
• Checking with a doctor before starting new medications

Tracking symptoms can also help identify early warning signs before a flare becomes severe.

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Monitoring Symptoms Matters

Because ulcerative colitis can change quickly, paying attention to your body is important. If you're experiencing symptoms and want to better understand whether they may be related to Ulcerative Colitis, a free online symptom checker can help you organize what you're feeling and guide your next steps—though it should never replace a consultation with your doctor.

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Living With the Unpredictability of Ulcerative Colitis

It can be frustrating and unsettling when ulcerative colitis symptoms worsen without much warning. Many people worry that a sudden flare means they are "failing" treatment or doing something wrong. In reality, ulcerative colitis is a complex immune condition, and flares can happen even when someone is doing everything right.

The good news is that treatment options for ulcerative colitis continue to improve, and many people achieve long periods of remission with the right care plan.

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The Bottom Line

• Ulcerative colitis symptoms can worsen suddenly, sometimes over a short period of time
• Sudden flares may be triggered by missed medications, infections, stress, diet changes, or disease progression
• Some flares are mild, but others can be serious and require urgent care
• Early recognition and treatment can reduce complications and speed recovery

If you experience sudden or severe symptoms, speak to a doctor as soon as possible—especially if there is heavy bleeding, severe pain, fever, or signs of dehydration. Prompt medical attention can be life-saving and can help you regain control of your ulcerative colitis safely and effectively.