Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that causes inflammation in the lining of the large intestine, including the colon and rectum. This condition brings a range of digestive symptoms, including changes in stool appearance and bowel habits.

UC symptoms typically follow a cyclical pattern, alternating between remission and flare-ups. During remission, symptoms are milder or less frequent due to controlled inflammation. In contrast, flare-ups lead to more noticeable changes in how often and how your stool appears and smells.

What Does Ulcerative Colitis Poop Look Like?

Everyone's stool is slightly different, but generally, healthy poop is brown and shaped like a snake or sausage. Ulcerative colitis may alter the color, texture, and even the smell of stool due to ongoing inflammation in the large intestine.

Texture

Poop in people with UC is often looser than normal. Inflammation affects the colon's ability to absorb fluids and electrolytes from waste, leading to watery stools. Some individuals may also have bulky stools if they experience malabsorption. Malabsorption happens when inflammation prevents proper nutrient absorption, resulting in greasy or oily stools that may float.

Color

Stool may contain bright red blood due to ulcers and bleeding in the intestinal lining. Blood can also be present in the toilet bowl or on toilet paper. Increased mucus production in response to inflammation may result in jelly-like mucus that appears white or yellow. In severe cases, stools during flare-ups might consist mostly of blood and pus.

Smell

Stool typically has an odor, but during UC flare-ups, it can become especially foul. Contributing factors include changes in the gut microbiome, malabsorption, and the presence of gastrointestinal infections. These issues can result in more pungent-smelling stool than usual.

How Ulcerative Colitis Affects Your Bowel Habits

UC can significantly disrupt regular bowel habits. Changes may include how often you go, how urgently you need to go, and even the ability to control bowel movements.

Frequency

Healthy bowel movement frequency ranges from three times per week to three times per day. However, during a UC flare-up, diarrhea often occurs, meaning three or more loose stools per day. Inflammation makes it difficult for the colon to absorb water, causing stools to pass through more quickly.

Diarrhea can interfere with sleep, work, school, and daily routines. Some people with UC may also experience constipation, especially when inflammation is limited to the left side of the colon. In such cases, stool may move slowly through the right colon, resulting in hard, dry, and infrequent stools.

Urgency

A sudden and intense urge to have a bowel movement is one of the most common and disruptive symptoms of UC. This urgency may come with little warning and can be distressing, especially in public or unfamiliar settings. It often causes anxiety and interferes with daily activities.

Fecal Incontinence

When inflammation weakens the anal sphincter muscles, it may lead to accidental leakage of stool. This can occur during flare-ups or even remission. In some cases, urgency combined with limited access to a bathroom results in fecal incontinence. Many individuals underreport this symptom, though it significantly impacts quality of life.

Tenesmus

Tenesmus is the feeling of needing to poop even when the bowel is empty. Inflammation in the rectum often causes this persistent urge. People may strain hard during bowel movements, but pass little or no stool.

Treatment

UC symptoms, such as diarrhea and urgency, can reduce quality of life and lead to anxiety or social withdrawal. Fortunately, lifestyle changes and medical treatments are available to manage inflammation and ease symptoms.

Home Management

  • Diet: Adjusting your diet may reduce inflammation. Consider limiting foods that aggravate symptoms, such as dairy, sugar, fatty foods, red meat, alcohol, caffeine, and spicy or high-fiber foods. Keep a food diary to identify personal triggers.

  • Hydration: Frequent diarrhea may cause dehydration. Drinking fluids throughout the day helps maintain hydration and support digestion.

  • Stress Management: Stress can worsen symptoms. Practice relaxation techniques such as meditation, yoga, or deep breathing to help manage stress.

  • Be Prepared: Carry supplies like toilet paper, wet wipes, a change of clothes, air freshener, and hand sanitizer to help handle emergencies when you're not at home.

Medical Treatment

UC is a lifelong condition that often requires ongoing treatment. Medications and, in some cases, surgery can help reduce inflammation and control symptoms. Many people with UC achieve remission through treatment.

  • Aminosalicylates: These medications reduce inflammation and may be taken orally or rectally. Mesalamine is a common option.

  • Corticosteroids: Potent anti-inflammatory drugs used for short-term relief in moderate-to-severe cases.

  • Immunomodulators: These suppress the immune system and help manage inflammation over time.

  • Biologics: Target specific proteins that drive inflammation in the intestines.

  • Surgery: May be necessary when other treatments fail or complications arise. Surgery usually involves removing the large intestine.

How Poop Helps With Diagnosis

When you report symptoms like bloody stool or frequent diarrhea, your healthcare provider may request stool tests to help confirm a diagnosis or rule out other conditions.

  • Fecal Occult Blood Test: Detects hidden blood in the stool.

  • Calprotectin Test: Measures calprotectin, a protein released during intestinal inflammation.

  • Stool Culture Test: Identifies bacterial infections that may be contributing to symptoms.

While stool tests provide useful information, they cannot definitively diagnose UC. Imaging procedures like colonoscopy and biopsies are essential for a conclusive diagnosis.

When To See a Healthcare Provider

Consult a healthcare provider if you experience persistent symptoms such as:

  • Frequent diarrhea

  • Blood, mucus, or pus in your stool

  • Rectal bleeding

  • Abdominal pain or cramping

  • A feeling of incomplete bowel movements

  • Urgency to defecate

If you are already diagnosed with UC, see your provider for any new or worsening symptoms, including:

  • Persistent or heavy diarrhea

  • Rectal bleeding with clots

  • Ongoing abdominal pain

  • Fever

A Quick Review

Ulcerative colitis can cause various changes in your stool, including differences in texture, color, smell, and bowel habits. You may notice looser stools, blood or mucus in the stool, or foul odors. UC may also increase the frequency, urgency, and risk of fecal incontinence.

If you observe changes in your bowel habits, speak to a healthcare provider. Early diagnosis and effective treatment can reduce inflammation and help restore normal bowel function.