All NewsReceiving a diagnosis of ulcerative colitis (UC) can feel overwhelming. Many patients come to us after months—or even years—of unexplained symptoms, uncertainty, and frustration. Understanding how UC is diagnosed can ease anxiety and help you take an active role in your care.
What Is Ulcerative Colitis?
Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes ongoing inflammation and sores (ulcers) in the lining of the large intestine, starting in the rectum and sometimes extending through part or all of the colon. UC is a chronic (long-term) condition, but with the right diagnosis and treatment plan, many patients can control symptoms and maintain an excellent quality of life.
When Should You See a Doctor?
Consider seeing a gastroenterologist if symptoms persist for more than a couple of weeks or begin to disrupt daily life. Common symptoms include:
- Ongoing diarrhea
- Blood and/or mucus in the stool
- Urgency (difficulty holding stool)
- Cramping or abdominal pain
- Waking from sleep to have a bowel movement
- Feeling like you still need to go even after you’ve just gone
- Fatigue, low energy, or unexplained weight loss
→ Call urgently or seek care right away if you have heavy bleeding, fever, severe abdominal pain, dizziness/fainting, signs of dehydration, or you can’t keep fluids down.
Step One: Medical History and Symptom Review
Diagnosis starts with a detailed conversation. We’ll discuss your symptoms, timing, triggers, family history, medications (including NSAIDs), recent travel or antibiotic use, and any recent infections. This step matters because several conditions—including infections and irritable bowel syndrome (IBS)—can share overlapping symptoms.
Step Two: Lab and Stool Testing
Blood and stool tests help us look for inflammation, anemia, dehydration, and infections that can mimic UC. Depending on your situation, this may include tests that check:
- Anemia (low blood count)
- Inflammation in the body
- Infection, including C. difficile (especially after antibiotics)
- Inflammation in the intestines, using specialized stool markers
These tests don’t diagnose UC by themselves, but they provide important clues and guide next steps.
Step Three: Colonoscopy
A colonoscopy is the most important tool for diagnosing ulcerative colitis. During this procedure, we examine the lining of the colon and rectum with a small camera. If inflammation is present, we take tiny tissue samples (biopsies) to confirm the diagnosis and rule out other causes. Most patients are comfortably sedated and don’t remember the procedure.
Step Four: Imaging (When Needed)
Sometimes imaging tests such as a CT scan or MRI are used to assess the extent of inflammation or to evaluate possible complications—especially if symptoms are severe. Imaging is typically used alongside, not instead of, colonoscopy and biopsy results.
Why Diagnosis Can Take Time
UC symptoms can overlap with infections, medication effects, IBS, and other inflammatory conditions. For that reason, diagnosis is often a process rather than a single test. While waiting can be frustrating, a careful step-by-step approach helps ensure the most accurate diagnosis and the best treatment plan.
What Happens After Diagnosis?
After UC is confirmed, we’ll talk about the severity and extent of inflammation (for example, inflammation limited to the rectum versus more widespread disease). That information helps us choose the right treatment. The goal is to reduce inflammation, control symptoms, and maintain remission, with ongoing follow-up to keep you feeling your best.
Support at Every Step
At Gastroenterology Associates, our team provides comprehensive care for digestive health, including inflammatory bowel disease. If you’re experiencing persistent symptoms or have questions about evaluation or treatment, we’re here to help. Please don’t hesitate to text 864-589-6714 or schedule a visit with one of our providers.
Written by Dr. David Palma, Gastroenterologist
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