Colitis refers to inflammation of the colon, or large intestine. There are several types of colitis, including ulcerative colitis and Crohn’s colitis. Inflammation from colitis can cause changes in bowel habits, abdominal pain, fatigue, and other symptoms. One of the most common symptoms of colitis is diarrhea, which can lead to changes in the appearance of poop.
What is colitis?
Colitis refers to inflammation of the inner lining of the colon, also called the large intestine or bowel. There are a few different types of colitis:
- Ulcerative colitis – Chronic inflammation and ulcers along the innermost lining of the colon and rectum.
- Crohn’s colitis – Inflammation that can affect any part of the gastrointestinal tract, including the colon, in people with Crohn’s disease.
- Infectious colitis – Inflammation from a bacterial, viral, or parasitic infection.
- Ischemic colitis – Inflammation of the colon due to inadequate blood flow.
- Chemical colitis – Inflammation caused by irritation from chemicals in the colon.
The most common types are ulcerative colitis and Crohn’s colitis. Colitis causes inflammation and irritation of the colon lining, which can lead to symptoms like diarrhea, rectal bleeding, abdominal pain and cramping, urgency to have a bowel movement, fatigue, reduced appetite, and weight loss. The inflammation can also cause changes in the appearance and consistency of poop.
How does colitis affect poop?
Some of the most common symptoms of colitis involve changes in poop, including:
- Diarrhea – Frequent, loose, watery stools. This is due to inflammation making the colon less efficient at absorbing water.
- Blood in stool – Bright red blood or maroon/black tarry stools indicating bleeding from the inflamed colon lining.
- Mucus in stool – Due to excess mucus production from irritated colon tissue.
- Urgency – Feeling like you need to have a bowel movement right away.
- Tenesmus – Feeling like you need to poop but unable to pass stool.
- Incontinence – Accidental leakage of stool due to inability to control the urge.
These colitis-related symptoms can lead to changes in the frequency, consistency, color, shape, size, and smell of poop compared to normal.
What does normal poop look like?
Normal poop can range quite a bit in terms of color, shape, and consistency. However, here are some general guidelines for healthy stool:
- Color – Shades of brown, ranging from light tan to dark brown.
- Consistency – Soft and smooth, easy to pass. Well-formed, sausage shaped.
- Frequency – 1-2 bowel movements per day up to 3 times a week can be normal.
- Texture – It should hold its shape until flushed, not mushy or watery.
- Smell – May have mild odor, but not overly foul or strong smelling.
Keep in mind that normal stool can vary a lot between different people. But significant changes in your regular bowel habits could indicate a problem like colitis.
Characteristics of colitis poop:
Here are some specifics on what to look for with colitis poop:
Color
- Bright red – Fresh blood from bleeding in the colon. This is a common symptom of ulcerative colitis and Crohn’s colitis.
- Dark brown – Dried blood from past bleeding higher up in the GI tract. Can make stool appear black and tarry.
- Pale yellow – Can indicate insufficient bile production due to Crohn’s disease affecting the ileum part of the small intestine.
- Grayish – From inadequate digestion and absorption of fat, which leaves behind fat droplets that make stool look pale.
Consistency
- Watery diarrhea – Loose, liquid stools from inflammation impairing the colon’s ability to absorb water. Stool can contain mucus or appear bloody.
- Porridge-like – Mucus and blood from the inflamed colon can make stool have a sticky, slimy consistency.
- Thin, pencil-like – Narrow stool can be caused by strictures or scars in the colon narrowing the passageway.
Urgency and Frequency
- Need to suddenly rush to the bathroom.
- Feeling like you didn’t completely empty the bowels.
- Going more than 3 times a day, unable to control bowel movements.
Other characteristics
- Visible mucus – Colon inflammation results in increased mucus production and secretion.
- Foul smelling – Excess gas, mucus, and changes in stool composition can lead to bad odor.
- Flat ribbons or pieces – Stool may not hold together well and come out in scraps if the colon has reduced muscle tone.
What causes these changes in stool?
There are a few factors that contribute to the changes in poop texture, color, and composition with colitis:
- Ulcerations – Open sores along the colon lining bleed, producing blood in stool.
- Inflammation – Swelling and irritation leads to discharge of mucus, diarrhea, and urgent bowel movements.
- Changes in motility – Disruptions in muscular contraction ability affecting stool consistency.
- Bacteria imbalance – Excess “bad” bacteria produce gas, odor, and digestive issues.
- Medications – Some colitis drugs like antibiotics and antidiarrheals impact stool formation.
Monitoring symptoms like frequent diarrhea, abdominal pain, blood or mucus in stool, and the visual characteristics of bowel movements is important for identifying disease flares and guiding treatment.
When to see a doctor
Contact your doctor if you experience:
- Diarrhea lasting more than 3 days
- Bloody stool
- Intense or worsening abdominal pain
- Fever over 101°F
- Significant unintentional weight loss
- Inability to keep food or liquids down
Sudden severe symptoms like high fever, excessive vomiting, confusion, or blood pressure changes could indicate a gastrointestinal emergency needing immediate medical care.
Seeing a gastroenterologist can help diagnose the cause of symptoms and identify the type of colitis through tests like:
- Stool sample analysis
- Blood tests
- Colonoscopy with biopsies
- CT scan
- Flexible sigmoidoscopy
Keeping a symptom diary tracking your bowel movements, any pain, what you eat, and medications can help the doctor identify potential triggers.
Treatments that affect colitis stool
Medications used for treating colitis can also lead to changes in stool.
Anti-inflammatories
Corticosteroids like prednisone and budesonide can reduce inflammation but may result in side effects like:
- Thin, pencil-like stool
- Watery diarrhea
- Urgent bowel movements
Immunosuppressants
Drugs that lower the immune response like azathioprine, mercaptopurine, and methotrexate can make you more susceptible to infections that cause colitis flare-ups with symptoms like:
- Cramps and diarrhea
- Bloody stool
- Mucus and pus in stool
Anti-diarrheals
Medications like loperamide or diphenoxylate with atropine help slow down bowel movements and make stool more solid. Potential side effects include:
- Hard, dry stool
- Straining to pass stool
- Bloating
- Nausea
Antibiotics
Antibiotics like metronidazole, ciprofloxacin, and sulfasalazine are used to treat bacterial infections or reduce inflammation in colitis. They can lead to side effects like:
- Watery diarrhea
- Cramps or tenderness
- Nausea or vomiting
- Yeast infections
Lifestyle changes to improve colitis symptoms
Diet and lifestyle adjustments can help manage colitis flare-ups:
- Avoid problem foods – Dairy, alcohol, caffeinated drinks, fatty or spicy foods could trigger symptoms.
- Eat smaller meals – Large volumes can overwhelm your colon’s reduced capacity.
- Stay hydrated – Drink fluids like water, herbal tea, or broths to replace lost fluids from diarrhea.
- Take probiotics – These support gut bacteria and digestive health.
- Reduce stress – Find healthy ways to manage stress which can worsen colitis symptoms.
- Consider supplements – Vitamin D, fish oil, curcumin, and boswellia may reduce inflammation.
- Quit smoking – Smoking increases flare-up risk in ulcerative colitis.
Keep a food and symptom diary to identify trigger foods. Finding an individualized diet and stress management plan that works for you can help minimize colitis flares and return your bowel movements closer to normal.
When to seek emergency care
Seek immediate medical attention if you experience:
- High fever over 102°F
- Blood pressure drops
- Confusion, dizziness, or fainting
- Intense or constant abdominal pain
- Vomiting blood
- Large amounts of bloody stool
- Inability to drink fluids due to nausea/vomiting
These can indicate a serious complication like perforation, toxic megacolon, sepsis, or severe dehydration requiring hospitalization.
When to see a gastroenterologist
Schedule an appointment with a gastroenterologist if you have:
- Prolonged diarrhea lasting over 2-3 weeks
- Recurring bloody or mucus-filled stool
- Persistent abdominal pain and cramping
- Unintentional weight loss of over 10 lbs
- Low-grade fever and fatigue
- Family history of inflammatory bowel disease (IBD)
A gastroenterologist can help diagnose the cause of your symptoms, perform tests to evaluate the extent of inflammation, provide medications to reduce flare-ups, and monitor your condition for complications.
Bottom line
Colitis can significantly impact the color, consistency, frequency, and other characteristics of bowel movements. Prolonged diarrhea, bloody or mucus-filled stool, smelly poop, and urgent bathroom trips are common colitis symptoms. These are due to inflammation damaging the colon lining, causing changes in motility, bleeding, and excess mucus production.
Tracking your stool characteristics and symptoms can help identify disease flares so you can adjust your treatment. Seeing a gastroenterologist for proper diagnosis and management is important, especially if symptoms are severe or persist. With the right medications, lifestyle changes, and monitoring, it’s possible to minimize symptoms and start having more normal poop again during periods of colitis remission.