Symptoms of Inflammatory Bowel Disease

Symptoms

Ulcerative Colitis (UC)

Crohn's Disease (CD)

Diarrhea

Recurrent diarrhea is very common, but onset may be very gradual and mild or it may not be present. Feces may also contain mucus.

Recurrent diarrhea is fairly common.

Rectal bleeding

Blood is almost always present in stools. It may be readily visible or visible using only a microscope (called occult blood).

Bleeding not as common as in UC, but can occur.

Constipation

Constipation can be a symptom of UC, but not as common as diarrhea. Can occur during flare-ups. May occur when the inflamed rectum triggers a reflex response in the colon that causes it to retain the stool.

Constipation in Crohn's disease is usually a symptom of obstruction in the small intestine.

Abdominal symptoms

Pain is not prominent symptom, but can vary. May cause vague discomfort in the lower abdomen, an ache around the top of the hipbone, or cramps in the middle of the abdomen. Severe pain can occur during flare-ups. Vomiting and nausea.

Hallmark symptom is recurrent episodes of pain in the lower right part of the abdomen or above the pubic bone. Often preceded by and relieved by defecation. Bloating, nausea, and vomiting may also occur. Intestinal pain may also be an indication of a serious condition, such as an abscess, or a perforation of the intestinal wall.

Fever

May occur with severe attacks.

Usually low-grade. Spiking fever and chills indicates complications.

Loss of appetite, weight loss, and impaired growth in children

Often not evident in mild or even moderately severe UC. Occasionally impairs growth in children and teenagers.

Common. Typical weight loss is 10 -20% of normal. Commonly impairs growth in children and teenagers.

Abnormal defecation: Increased frequency, a feeling of incomplete evacuation, and tenesmus (a painful urge for a bowel movement even if the rectum is empty). Fecal incontinence.

Symptoms may be mild or severe.

Can occur in active stages.

Anal ulcers and fistulas: (channels that can burrow between organs, loops of the intestine, or between the intestines and skin).

Almost never a symptom.

Fistulas and ulcers around the anus may be early symptoms of CD.

Neurologic or psychiatric symptoms

No.

May be early signs of Crohn's disease when accompanied by gastrointestinal problems.

Note: A 2001 study reporting that early symptoms (called a prodrome) may appear in Crohn's disease, starting about 7 years before the full-blown symptoms occur. The prodrome symptoms included bloating, diarrhea, stomach pain, fever, weight loss, and fatigue. The prodromal period in ulcerative colitis is much shorter (about a year).