Diagnosing ulcerative colitis
Getting diagnosed with ulcerative colitis (UC) can take time. That’s because the symptoms of UC can be similar to other conditions and there’s no single medical test for it. UC may be progressive in some patients, which means it may get worse over time.
Getting diagnosed with UC
Your healthcare provider may perform a physical exam, ask about your family medical history and use a combination of testing methods to make a diagnosis. UC is diagnosed using endoscopic procedures with a tissue biopsy. However, additional tests may also be used to help get more information about your condition.
Some of these tests and procedures may also be performed throughout your journey with UC to assess disease activity and how you may or may not be responding to therapy.
Blood tests
A type of protein that can be found in the blood. If there are higher levels of this protein, it means there is inflammation occurring in the body.
This test is used to find out if there is inflammation in the body based on how quickly red blood cells settle in a test tube.
This test measures your red and white blood cells, as well as hematocrit, hemoglobin, and platelets.
Imaging tests
An X-ray of your abdomen can help assess different issues in your digestive system.
A CT scan uses X-rays along with a computer to create detailed images of your gut and surrounding areas.
An MRI uses a magnetic field and radio waves to create images of your gut and surrounding areas without any exposure to radiation.
Endoscopic procedures & biopsy
A biopsy is a procedure that collects a tissue sample that is later examined under a microscope. A tissue sample can be taken from your digestive tract during an endoscopic procedure.
This procedure gives an inside look of your entire colon using a tiny tube that has a camera on the end.
This procedure uses a tiny tube that has a camera on the end to examine your rectum and sigmoid colon, which is the last part of your colon.
Stool tests
Fecal calprotectin levels can be used as a marker to detect inflammation in the intestine.
Severity and progression
There is no single test to assess and monitor UC progression. Different clinical measures, how your symptoms impact your life, along with complications of the disease and of therapy will factor into how your healthcare provider makes an assessment related to your disease severity and progression. Your healthcare provider may also perform colon cancer screenings, given the increased risk of it when you have UC. There are other things that help care teams determine the severity of your UC. That information can typically be found by using a combination of testing and imaging.
See the table below for more information on the levels of severity.
| Number of stools per day | Stools are formed |
| Blood in stools | None |
| Urgent need to go to the bathroom | None |
| Number of stools per day | Less than 4 |
| Blood in stools | Sometimes |
| Urgent need to go to the bathroom | Occasional |
| Number of stools per day | More than 6 |
| Blood in stools | Frequent |
| Urgent need to go to the bathroom | Often |
| Number of stools per day | More than 10 |
| Blood in stools | Continuous |
| Urgent need to go to the bathroom | Continuous |
| Remission | Mild | Moderate-severe | Fulminant | |
| Number of stools per day | Stools are formed | Less than 4 | More than 6 | More than 10 |
| Blood in stools | None | Sometimes | Frequent | Continuous |
| Urgent need to go to the bathroom | None | Occasional | Often | Continuous |
Seeking care
The following may be symptoms of a flare-up, and you should seek care if you’re experiencing any of them.
Ongoing diarrhea
Diarrhea that awakens you from sleep
A fever lasting more than a day or two
Blood in the stool
Abdominal pain (or stomach pain or cramping)
Is there a specialist for UC?
Often, a gastroenterologist—a doctor specializing in the digestive system—oversees UC care.
Your IBD care team
A multidisciplinary inflammatory bowel disease (IBD) care team typically includes healthcare professionals from different specialties. The goal is to offer all-encompassing care to support the physical, mental, and emotional impacts of the disease.
Your team may include a gastroenterologist, primary care physician (PCP), pharmacist, psychologist, social worker, registered dietitian or nutritionist, nurse or nurse navigator, or colorectal surgeon.
Prepare for your next appointment
Talking with your care team about your symptoms can be scary. Being prepared can help. Before your next appointment, consider doing the following:
- Jot down exactly what’s going on with your body and any concerns you have
- Ask a friend/family member to come with you
- Trust yourself and be your own advocate
We can help you get started with a personalized discussion guide that's tailored to you—and your gut.
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Ulcerative colitis brochure
Understand what UC is, how it’s different from Crohn’s, and how it’s treated and monitored.
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