Inflammatory Bowel Disease (IBD) Symptoms

Inflammatory bowel disease (IBD) symptoms include abdominal pain, bloody stools, unintentional weight loss, diarrhea, and more. Symptoms can be mild to severe.

Inflammatory bowel disease involves ongoing inflammation of all or part of your digestive tract. Three conditions are categorized as IBD: Crohn's disease (CD), ulcerative colitis (UC), and indeterminate colitis (IC).

Many other symptoms may also be present, and the pain may affect different areas of the digestive system, depending on the disease. Your specific set of symptoms can help your healthcare provider determine whether you have IBD and, if so, which type.

Frequent Symptoms

IBD is a painful condition and some of its symptoms can be worrisome. While there's a fair amount of overlap between the different types of IBD, each has its own potential set of symptoms.

IC is diagnosed when it's not clear whether the condition is Crohn's or ulcerative colitis because the disease does not fit the whole picture of each condition, so any combination of symptoms can be seen in IC.

Rectal Bleeding

Bleeding from the rectum, or seeing blood in the stool, is never a normal occurrence, and it is one of the symptoms of IBD.

Blood in the stool is a common symptom of UC and IC. It's less frequent in Crohn's disease. There are times when it can be a serious concern, leading to significant blood loss.

Mucus in the Stool

Mucus is a normal part of stool but it isn't usually visible, and it is not always a cause for concern. If you have enough mucus in the stool that you can see it, there could be several reasons why.

People with ulcerative colitis or Crohn's disease sometimes pass visible amounts of mucus in their stool, either as a result of ulcers in the colon or possibly due to an anal fissure (a tear or split in the skin).

People who have had surgery for ulcerative colitis and have a j-pouch (ileal pouch-anal anastomosis, or IPAA) may also pass mucus, which could be a sign of a condition called pouchitis. 

Abdominal Pain

Abdominal pain (usually described as stomach pain) can be a symptom of many different conditions.

• People with ulcerative colitis tend to have cramp-like pain that is located in the lower left portion of the abdomen.
• People with Crohn's disease tend to have pain in the middle or lower-right abdomen (although pain could show up in other parts of the abdomen too).

Not everyone with IBD has pain, and the pain may come and go, sometimes occurring after a meal or relieved by having a bowel movement.

Persistent Diarrhea

Diarrhea has many causes, and even healthy adults may have diarrhea a few times a year. Often, diarrhea resolves on its own, and the cause may go undiscovered. Persistent diarrhea lasting more than three days can be a sign of a problem that might need treatment.

People with IBD often have episodes of "explosive diarrhea" several times a day. This type of diarrhea is just as the name implies—rapid, sudden, and severe. It may involve anywhere from three up to 10 or even 20 watery bowel movements daily.

Unintended Weight Loss

Losing weight without restricting calories or exercising is usually a sign of a medical issue.

Diarrhea, lack of appetite, and active inflammation resulting in protein-losing enteropathy can result in unintended weight loss.

Your healthcare providers may recommend that you gain weight when IBD is in remission. Be sure to gain weight in a healthy way—by eating fresh, nutrient-rich foods that are minimally processed.

Rare Symptoms

In rare cases, some people with IBD may also experience:

• Fevers
• Fatigue
• Joint pain
• Skin rashes
• Vision changes
• Episcleritis (inflammation of the white of the eye)
• Increased menstrual symptoms
• Flare-ups of IBD symptoms before or during a menstrual period

Talk with your medical team for help in managing these symptoms if you have them.

IBD vs. IBS

Irritable bowel syndrome (IBS) and IBD sometimes get confused because they have similar names and abbreviations. They are both lifelong, chronic intestinal conditions; some of the symptoms can be similar, such as abdominal pain, cramping, and changes in bowel movements.

However, there are important differences in several symptoms:

• IBS: common symptoms include gas and bloating
• IBD: common symptoms include inflammation, bloody stools, fatigue, reduced appetite, and unintended weight loss

Complications

IBD is hard on your intestines and various systems in your body. Over time, and especially if treatment is delayed or inadequate, some people develop serious complications.

Potential complications of IBD include:

• Bowel obstruction
• Bowel perforation
• Intestinal abscesses
• Intestinal fistulas
• Intestinal fissures
• Toxic megacolon
• Colorectal cancer

Some complications that may occur outside of the digestive system include:

• Delayed growth (in children)
• Eye disease (episcleritis, scleritis, iritis, uveitis)
• Arthritis (ankylosing spondylitis, sacroiliitis, axial arthritis, peripheral arthritis)
• Osteoporosis
• Increased risk of gallstones
• Increased risk of kidney stones
• Liver disease
• Neurological symptoms, which can be severe
• Anemia
• Blood and circulatory problems
• Mouth ulcers
• Difficulty getting pregnant

When to See a Healthcare Provider

If you're experiencing ongoing or severe digestive symptoms, you should see your primary care physician. Due to the complexities involved in the diagnosis, you may be referred to a gastroenterologist.

See a healthcare provider if you experience:

• Significant abdominal pain
• Blood or significant mucus in the stool
• Unexplained weight loss
• Diarrhea that doesn't resolve within a few days

Seek immediate medical care if you have:

• Severe abdominal pain
• Substantial rectal bleeding
• Significant abdominal pain accompanied by vomiting, nausea, or fever
• Blood or mucus in the stool accompanied by diarrhea, pain, or vomiting

Summary

IBD symptoms can be mild to severe. Common symptoms include bloody stools, abdominal pain, unintentional weight loss, and diarrhea. Over time, and especially if treatment is delayed or inadequate, some people develop serious complications. If you're experiencing ongoing digestive symptoms, talk to your healthcare provider as soon as possible.