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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Partly. A doctor can assess symptoms and flare-ups by video and help with mild flare-ups and repeat medicines; diagnosis, severe flare-ups and specialist medicines need in-person care.
- What it is: a lifelong condition in which the rectum and large bowel (colon) become inflamed and develop ulcers, with flare-ups and periods of remission.
- How common: at least 1 in every 233 people in the UK live with it, and most are diagnosed between the ages of 20 and 40.
- Main symptoms: diarrhoea with blood or mucus, an urgent need to poo, and cramping tummy pain, mainly in the lower left side.
- Emergency: call 112 for severe tummy pain, non-stop bleeding from the bottom or large clots, or vomiting blood.
Do not book a video appointment if you have severe tummy pain, a swollen, tender tummy with a high temperature, non-stop bleeding from the bottom or large clots when you poo, or vomit that contains blood or looks like coffee grounds. Call 112 or go to an emergency department. Six or more bloody poos a day with a high temperature, a fast heartbeat or feeling very unwell is a severe flare-up that needs hospital treatment.
Can an online doctor treat ulcerative colitis?
Partly. Ulcerative colitis is diagnosed with blood and stool tests and a colonoscopy, and severe flare-ups are treated in hospital. A doctor by video can assess new bowel symptoms and tell you which tests you need, judge how severe a flare-up is and whether it needs hospital care, help with a mild flare-up in line with your specialist’s plan, review repeat medicines, including when they run out abroad, and help with tiredness, low iron and the strain of living with a long-term condition.
How an online consultation helps with ulcerative colitis
- How severe is this flare-up?: How often you go, blood, temperature and pulse show whether it is mild or needs hospital care.
- New symptoms taken seriously: Bloody diarrhoea that lasts needs tests, and the doctor explains which ones and where.
- Your plan, continued: Repeat medicines and help with a mild flare-up, in line with your IBD team’s plan.
- Travel and daily life: Medicines abroad, vaccines, tiredness, low iron, and the effect on work and mood.
What the doctor checks in an online ulcerative colitis consultation
The doctor checks for the signs of a severe flare-up first. The doctor asks about:
- Warning signs: severe tummy pain, a swollen or tender tummy, heavy bleeding or clots, a high temperature, a fast heartbeat, or feeling faint.
- Your bowels: how many times a day you go, including at night, how much blood or mucus there is, and how urgent it feels.
- The rest of you: tiredness, weight loss, painful joints, red or painful eyes, mouth ulcers and skin changes.
- Possible triggers: a recent stomach bug, travel, antibiotics, painkillers such as ibuprofen, stress, and missed medicines.
- Your treatment: your diagnosis, the medicines you take and how, your last colonoscopy and blood tests, and your IBD team’s plan.
- Your health: pregnancy or plans for it, other conditions, and smoking.
Before the call, note how many times you have opened your bowels each day this week, whether there was blood, and your temperature. Have your medicines and your IBD team’s contact details to hand.
What is ulcerative colitis?
Ulcerative colitis is a type of inflammatory bowel disease (IBD). The lining of the rectum and the large bowel (colon) becomes inflamed and develops ulcers, which can bleed. It usually starts in the rectum and can spread up the colon. It is lifelong, and most people move between flare-ups and periods of remission with few or no symptoms. It is not contagious.
How common is ulcerative colitis?
At least 1 in every 233 people in the UK live with ulcerative colitis, and most are diagnosed between the ages of 20 and 40. A review by the European Crohn’s and Colitis Organisation estimated that 2.5 to 3 million people in Europe have inflammatory bowel disease.
What causes ulcerative colitis? Is it autoimmune?
The exact cause is not known. It is thought to be autoimmune, with the immune system attacking the bowel, although experts are not certain. Genes, a weak gut barrier, the balance of gut bacteria and the environment all seem to play a part. The risk is higher with a family history or if you used to smoke, although most people with a relative who has it never develop it.
What are the symptoms of ulcerative colitis?
The main symptoms are diarrhoea that may contain blood, mucus or pus, a frequent, urgent or night-time need to poo, and tummy pain, mainly in the lower left side, that may ease after you go. Other symptoms include:
- bleeding from the bottom, and feeling you need to poo when your bowel is empty
- excess wind or bloating
- constipation, which is common when only the rectum is inflamed
- tiredness, a poor appetite and weight loss without trying
- anaemia, usually from low iron
A flare-up can last from a few days to several months. Possible triggers include stress, infections, changes in medicines and anti-inflammatory painkillers such as ibuprofen or aspirin, and sometimes there is no obvious trigger.
Symptoms outside the bowel
As many as 1 in 5 people with ulcerative colitis develop problems elsewhere in the body, often during flare-ups: painful or swollen joints, red, itchy or painful eyes, mouth ulcers, and red or darker skin patches called erythema nodosum. A painful red eye with blurred vision can be serious and needs urgent care.
What are the types and stages of ulcerative colitis?
Ulcerative colitis has no fixed stages. Doctors describe it in two ways: how much of the bowel is inflamed, and how severe a flare-up is. Grading the flare-up decides where it is treated.
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| Type | Part of the bowel inflamed | Long-term bowel cancer risk |
|---|---|---|
| Proctitis | The rectum only; about 1 in 10 people later develop colitis that affects most of the colon | Not increased |
| Left-sided (distal) colitis, including proctosigmoiditis | The rectum and the left side of the colon | Raised, but less than with extensive colitis |
| Extensive colitis or pancolitis | Most of the colon, or all of it | Raised the most |
How severe is a flare-up?
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| Severity | Poos a day | Blood and other signs | Where it is usually treated |
|---|---|---|---|
| Mild | Fewer than 4 | Blood less than half the time; no fever or anaemia | At home, often with your usual plan |
| Moderate | 4 to 6 | Blood half the time or more; some signs of inflammation on tests | At home, with prompt help from your IBD team |
| Severe | 6 or more | Visible blood, and tests show inflammation | Your IBD team, urgently |
| Acute severe | 6 or more bloody poos | With a high temperature, a fast heartbeat or feeling very unwell | Hospital, now |
These four grades are what people usually mean by the stages of ulcerative colitis. Very severe colitis can mean more than 10 bloody poos a day.
Ulcerative colitis, Crohn’s disease or IBS?
Ulcerative colitis and Crohn’s disease are the two main types of inflammatory bowel disease. IBS can cause similar symptoms but is a different condition:
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| What differs | Ulcerative colitis | Crohn’s disease | IBS |
|---|---|---|---|
| Where | The rectum and colon, starting at the rectum | Anywhere from the mouth to the bottom | The gut, without inflammation |
| Inflammation and ulcers | Yes, in the lining | Yes | No |
| Blood or mucus in poo | Common | Can happen | No blood |
| Tests that help | Stool calprotectin, blood tests, colonoscopy and biopsy | The same, plus MRI or CT scans of the small bowel | A stool calprotectin test helps tell it apart from IBD |
Microscopic colitis is a separate condition, also grouped with IBD. The Crohn’s disease, inflammatory bowel disease and IBS pages cover them in more detail.
Is ulcerative colitis serious? Complications and life expectancy
Ulcerative colitis is rarely life-threatening, but a severe flare-up may need hospital treatment. Possible complications include:
- Anaemia and low vitamins and minerals: anaemia affects about 1 in 5 people, usually from low iron, and calcium and vitamin D are often low too.
- Bowel cancer: the risk rises from about 8 to 10 years after symptoms start, mainly with extensive colitis, so a colonoscopy is advised 8 years after symptoms begin, then regular checks for those at higher risk.
- Weak bones (osteoporosis).
- Blood clots: the risk is higher during flare-ups, after surgery and when you cannot move about much.
- Toxic megacolon: rarely, severe inflammation makes the colon swell with gas, with a high temperature and a tender tummy. It needs urgent treatment.
- Liver and bile ducts: primary sclerosing cholangitis affects about 1 in 100 people with ulcerative colitis.
- Low mood and anxiety: common with a long-term bowel condition, and worth raising with a doctor.
What is the life expectancy with ulcerative colitis?
Most people with ulcerative colitis can expect to live a long life. Some studies find a slightly shorter life expectancy and others do not, and it is increasing.
Is ulcerative colitis a disability?
It can be. In the UK, it is not automatically a disability under the Equality Act 2010, but it may count as one depending on how much it affects daily life, and reasonable adjustments at work may then be available. In a 2019 UK survey, more than 1 in 3 people with Crohn’s or colitis considered themselves disabled.
What should you eat with ulcerative colitis?
There is no clear evidence that any food causes, cures or treats ulcerative colitis, and no single diet suits everyone. Some people find that certain foods make their symptoms worse, especially during a flare-up:
- Keep a food and symptom diary to find your own triggers.
- Speak to your doctor or a dietitian before cutting out whole food groups.
- Drink plenty of fluids when you have diarrhoea.
- Keep alcohol to no more than 14 units a week.
- Ask about iron, calcium and vitamin D, which are often low.
Which ulcerative colitis treatment might the doctor recommend?
Treatment depends on how much of the bowel is inflamed and how severe the flare-up is. This is the framework the doctors use, in line with the 2025 British Society of Gastroenterology guideline:
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Diarrhoea with blood or mucus for more than a few days, no diagnosis | Stool and blood tests, and referral to a specialist | Yes, to assess | For tests and a colonoscopy |
| Known colitis, mild flare-up | Your usual plan, often mesalazine tablets, suppositories or enemas | Yes | If it is not settling, or gets worse |
| Mild flare-up of proctitis | Mesalazine suppositories or enemas | Yes | If it is not settling |
| Moderate flare-up: 4 to 6 poos a day with blood | Your IBD team, and often steroid tablets | Partly | Contact your IBD team promptly |
| 6 or more bloody poos a day with a fever or fast heartbeat | Hospital admission | No | Go to hospital now |
| Stable colitis, repeat medicines | A review and repeat prescription, with up-to-date blood tests | Yes | For blood tests and specialist reviews |
| Medicines run out while abroad | A review of your usual medicines | Yes | Not usually needed |
| Joint pain, a red eye or skin patches | Assessment, and the right specialist | Yes, to assess | A painful red eye with blurred vision needs urgent eye care |
| Severe tummy pain, heavy bleeding or vomiting blood | Emergency care | No | Call 112 now |
Is this a flare-up you can manage at home? A doctor can tell you in one consultation, and when it needs hospital care.
See available times →Treatment options for ulcerative colitis
What you can do yourself
- Keep taking your medicines when you feel well: stopping makes flare-ups more likely.
- Avoid anti-inflammatory painkillers such as ibuprofen and aspirin unless a doctor advises them.
- Do not take loperamide or other medicines to stop diarrhoea during a flare-up.
- Drink plenty of fluids, and keep a symptom diary to show your IBD team.
- Keep up with the vaccines you are offered and with bowel cancer checks.
Prescription treatment
A prescription is never issued without a consultation. Aminosalicylates such as mesalazine are the first treatment for mild to moderate ulcerative colitis, as tablets, suppositories or enemas, and they also help keep it in remission; for proctitis, suppositories or enemas come first. Steroids such as prednisolone are used for short periods to bring a moderate or severe flare-up under control, not long term. Immunosuppressants, biologics and other targeted medicines are started and monitored by specialists. For a mild flare-up of known colitis, the doctor may prescribe a medicine from your usual plan and tells you when to contact your IBD team. If the doctor prescribes, use the prescription at a pharmacy near you.
Surgery
Surgery to remove part or all of the large bowel (colectomy) is considered when colitis badly affects daily life, the bowel is badly damaged, symptoms keep coming back or other treatments have not worked, and sometimes as an emergency in a severe flare-up. Afterwards, poo leaves the body through a stoma into a bag (ileostomy), or through an internal pouch joined to the bottom.
What does not help
Products sold as a quick cure: there is no cure in a week, and the evidence for herbal and other alternative remedies is limited. Stopping your medicines once you feel well, which makes a flare-up more likely.
Special situations
Pregnancy
Most people with ulcerative colitis have normal pregnancies and healthy babies, but a flare-up during pregnancy raises the risk of an early birth or a small baby. Speak to your IBD team before trying to conceive, and do not stop medicines without advice.
Travelling in Europe
Take enough medicine for the whole trip, with a list of what you take. Live vaccines, which include some travel vaccines, are not given while you take immunosuppressants, so plan vaccines early. A stomach bug can set off a flare-up; the travellers’ diarrhoea page covers prevention.
Mood, stress and work
Stress, anxiety and embarrassment are common and can affect social life, travel and sex. Talking therapies and support groups help, and the stress and anxiety pages cover what a doctor can do.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When ulcerative colitis is treated online, and when you need in-person care
Treated online: new bowel symptoms that need a plan for tests, mild flare-ups of known colitis, repeat medicines in line with your specialist’s plan, medicines that run out abroad, tiredness and low iron, and support with mood and work.
In-person care: colonoscopy, biopsies, blood and stool tests, moderate and severe flare-ups, biologics and other specialist medicines, surgery, and surveillance colonoscopies.
When to get in-person care
Call 112 or go to an emergency department now for:
- severe tummy pain, or a swollen, tender tummy with a high temperature
- non-stop bleeding from the bottom, or a lot of blood or large clots when you poo
- vomiting blood, or vomit that looks like coffee grounds
- 6 or more bloody poos a day with a high temperature, a fast heartbeat or feeling very unwell
- being unable to pass poo or wind
Get medical advice the same day for:
- very bad or bloody diarrhoea
- a high temperature, or feeling hot, cold or shivery
- a fast heartbeat
- a red, painful eye or blurred vision
- a flare-up that is getting worse despite treatment
If you already have a diagnosis, contact your IBD team about any flare-up that is not settling.
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your bowels: say how often you go, whether there is blood, how you feel in yourself, and which medicines you take, and have your IBD team’s plan to hand.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s ulcerative colitis? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Crohn’s disease can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about ulcerative colitis
What is ulcerative colitis?
Ulcerative colitis is a lifelong type of inflammatory bowel disease in which the lining of the rectum and colon becomes inflamed and develops ulcers. It causes bloody diarrhoea and an urgent need to poo during flare-ups, with calmer periods of remission in between.
What are the warning signs of ulcerative colitis?
The warning signs of ulcerative colitis are diarrhoea with blood or mucus, an urgent or night-time need to poo, cramping pain in the lower left tummy, tiredness and weight loss. Diarrhoea with blood that lasts more than a few days needs tests.
What are the 4 stages of ulcerative colitis?
There are no fixed stages, but doctors grade flare-ups as mild, moderate, severe or acute severe, by the number of poos a day, blood, and signs such as fever and a fast heartbeat. Acute severe colitis needs hospital treatment.
What causes ulcerative colitis?
The exact cause of ulcerative colitis is not known. It is thought to be autoimmune, and genes, gut bacteria and the environment seem to play a part. It is more likely with a family history or in people who used to smoke.
What foods should you avoid with ulcerative colitis?
No food has been shown to cause or cure ulcerative colitis, and no single diet suits everyone. A food diary helps find your own triggers. Speak to a doctor or dietitian before cutting out food groups, and keep alcohol within 14 units a week.
What can I do at home to manage ulcerative colitis?
Take maintenance medicine every day even in remission, keep a symptom diary with stool frequency and blood, learn your early flare signs and have a plan agreed with your specialist, eat a varied diet and only cut foods that reliably trouble you, use oral rehydration during a flare, avoid ibuprofen and similar painkillers, do not smoke, treat stress and sleep, keep vaccinations and bowel surveillance up to date, and carry a toilet card. Ulcerative colitis managed this way has fewer and milder flares.
How long does a flare-up last?
An ulcerative colitis flare-up lasts from a few days to several months, depending on how quickly treatment starts and how much of the bowel is inflamed; with the right medicine most mild flares settle within 2 to 4 weeks, while a severe flare needs hospital treatment. Some people go years without one, others have two or more a year, and keeping maintenance medicine going through remission is what makes flares rarer and shorter.
Can stress cause a flare-up?
Stress can trigger an ulcerative colitis flare-up in some people, along with infections such as a stomach bug, stopping or changing medicines, anti-inflammatory painkillers such as ibuprofen, some antibiotics and, oddly, stopping smoking; often there is no obvious trigger at all. Stress does not cause ulcerative colitis in the first place, but sleep, exercise, talking therapy and keeping maintenance medicine going all reduce the chance that a stressful period turns into a flare.
Can ulcerative colitis be cured?
There is no cure for ulcerative colitis, and no treatment cures it in a week. Medicines usually control it and keep it in remission, and surgery to remove the large bowel is an option when they do not.
What is the life expectancy with ulcerative colitis?
Most people with ulcerative colitis can expect to live a long life. Some studies find a slightly shorter life expectancy, and it is increasing over time.
Is ulcerative colitis a disability?
It can be. In the UK ulcerative colitis is not automatically a disability under the Equality Act 2010, but it may count as one depending on how much it affects daily life.
Is it ulcerative colitis, Crohn’s disease or IBS?
No. Crohn’s disease is the other main type of inflammatory bowel disease besides ulcerative colitis and can affect any part of the gut. IBS causes similar symptoms without inflammation, ulcers or blood in the poo.
Can an online doctor treat ulcerative colitis?
Partly. A doctor can assess ulcerative colitis symptoms and flare-ups by video, help with mild flare-ups and repeat medicines, and tell you when you need hospital care. Diagnosis, severe flare-ups and specialist medicines need in-person care.
- Ulcerative colitis, NHS, National Health Service (UK), reviewed 20 August 2026.
- British Society of Gastroenterology guidelines on inflammatory bowel disease in adults: 2025, Moran GW et al., Gut, British Society of Gastroenterology, 2025.
- Ulcerative colitis, Crohn’s & Colitis UK, updated April 2025.
- Symptoms and causes of ulcerative colitis, NIDDK, US National Institutes of Health, reviewed September 2020.
- Inflammatory bowel disease, NHS, National Health Service (UK), reviewed 11 September 2026.
- Crohn’s disease, NHS, National Health Service (UK), reviewed 14 April 2025.
- Who can and cannot take loperamide, NHS, National Health Service (UK), reviewed 10 April 2024.
- The burden of inflammatory bowel disease in Europe, Burisch J et al., ECCO-EpiCom, Journal of Crohn’s and Colitis, 2013.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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