Tag Archives: Bloody Diarrhea

Main Symptoms of Chronic Colitis

Chronic colitis is a long-standing inflammatory or ischemic process that damages the colonic mucosa and, in some forms, the deeper layers. It includes ulcerative colitis, Crohn colitis, microscopic colitis, diversion colitis, and chronic ischemic change. Symptoms wax and wane over months to years, and overlap with irritable bowel syndrome is common. Recognising the dominant pattern guides colonoscopic evaluation, histologic confirmation, and tailored therapy.

  1. Core lower-gut complaints
    Persistent or relapsing diarrhea: loose or watery stools ≥3 days per week for >4 weeks; may be bloody, mucus-laden, or purely watery depending on subtype.
    Abdominal pain: crampy, colicky, usually left-lower-quadrant, relieved transiently by defecation.
    Urgency and tenesmus: sudden compelling need to defecate with incomplete evacuation and prolonged straining.
    Visible blood or mucus: bright red coating, streaks, or clots mixed with stool; mucus may appear as clear slime.
  2. Systemic and metabolic clues
    Fatigue and malaise: chronic cytokine release and anemia.
    Weight loss: gradual reduction related to anorexia, nutrient loss, and increased catabolism.
    Low-grade fever <38 °C: appears during flares of active inflammatory bowel disease.
    Iron-deficiency anemia: from occult or overt chronic blood loss.
  3. Subtype patterns
    Ulcerative colitis: bloody diarrhea, urgency, left-sided pain; extraintestinal skin, eye, or joint manifestations.
    Crohn colitis: right-lower-quadrant pain, non-bloody diarrhea, palpable mass, perianal tags or fistulas.
    Microscopic colitis: watery diarrhea, nocturnal stools, normal endoscopic appearance, middle-aged women predominate.
    Chronic ischemic colitis: post-prandial cramps, bloody diarrhea in older adults with vascular risk factors.
    Diversion colitis: mucus discharge, urgency months after colostomy formation in unused distal segment.
  4. Complication markers
    Severe continuous bleeding with orthostatic dizziness, abdominal distension and absent bowel sounds (toxic megacolon), passage of large clots or melena suggesting proximal extension, and jaundice with hypoalbuminemia indicating advanced liver involvement in inflammatory bowel disease.

Summary table

SymptomTypical subtypeWarning threshold
Bloody diarrhea + urgencyUlcerative colitis>6 stools/day or orthostatic drop → hospitalize
Right-sided pain + massCrohn colitisObstruction, fever → imaging
Watery diarrhea, night stoolsMicroscopic colitis>8 stools/day → biopsy
Post-meal cramps + bloodIschemic colitisPersistent >48 h → vascular imaging
Mucus only, diverted colonDiversion colitisBleeding or pain → restore continuity

Related articles：

  1. Symptoms of Colitis
  2. What Causes Colitis
  3. Symptoms of Chronic Gastritis
  4. Chronic Superficial Gastritis: Common Symptoms and Clinical Manifestations
  5. What Chronic Diarrhea Is Telling You
  6. What are the symptoms and manifestations of bacterial dysentery?

What are the symptoms and manifestations of bacterial dysentery?

Bacterial dysentery is an acute invasive infection of the colon caused by Shigella, enteroinvasive or enterohemorrhagic Escherichia coli, Campylobacter, Salmonella enterica serovar Typhi or Paratyphi, and occasionally Yersinia. The hallmark is frequent, small-volume stools containing blood, mucus, or pus, accompanied by systemic toxicity. Rapid recognition guides stool testing, appropriate antibiotics, and prevention of secondary spread.

  1. Core intestinal features
    • Tenesmus: painful, ineffectual straining with a constant urge to defecate; patients may visit the toilet dozens of times daily.
    • Frequent scant stools: 8–20 passages per 24 h, each <100 g, often consisting only of blood-streaked mucus.
    • Gross blood and pus: bright-red blood mixed with stringy mucus or visible pus flakes; color darkens when transit is slower.
    • Cramping lower-abdominal pain: suprapubic or left-lower-quadrant, relieved transiently after each passage.
    • Urgency and fecal incontinence: inability to delay defecation more than a few minutes, especially in children.
  2. Systemic and toxic signs
    • High fever >38.5 °C, often exceeding 39 °C within 24 h of onset.
    • Malaise, headache, anorexia; vomiting is less prominent than in viral gastroenteritis.
    • Tachycardia and postural dizziness correlate with dehydration and systemic inflammation.
    • In severe Shigella infection (shigellosis): seizures in toddlers, altered consciousness, or hypotension indicating toxic megacolon.
  3. Variant presentations by pathogen
    • Shigella: shortest incubation (1–3 days), highest fever, most intense tenesmus; white blood cell casts in stool.
    • Campylobacter: prodrome of fever and myalgia, then bloody diarrhea; abdominal pain can mimic acute appendicitis.
    • Enterohemorrhagic E. coli: hemorrhagic colitis with little fever, risk of hemolytic-uremic syndrome 5–10 days after onset.
    • Salmonella Typhi: relatively less blood, more constitutional symptoms (“typhoid” pattern) with relative bradycardia and hepatosplenomegaly.
  4. Complication flags
    Continuous bleeding with orthostatic hypotension, abdominal distension and absent bowel sounds (suggesting megacolon), passage of large clots or melena (implying proximal extension), oliguria or tea-colored urine (microangiopathic hemolysis), and weight loss >5 % within one week.

Summary table

Symptom complexTypical pathogensWarning threshold
Blood-streaked mucus, high feverShigella>6 stools/h or seizures → hospitalize
Bloody diarrhea, mild feverEHECOliguria, pallor → check HUS markers
Crampy pain, leukocytes in stoolCampylobacterLocalized rebound → exclude appendicitis
Constipation followed by bloody stoolSalmonella TyphiRose spots, hepatomegaly → blood cultures
Persistent tenesmus, no improvementAnyDay 3 still febrile → consider antibiotic switch

Related articles：

  1. What Are the Symptoms of Dysentery
  2. What are the symptoms and manifestations of proctitis?
  3. Chronic Superficial Gastritis: Common Symptoms and Clinical Manifestations
  4. What are the symptoms and manifestations of irritable bowel syndrome?
  5. What are the symptoms and manifestations of irritable bowel syndrome?
  6. What are the symptoms and manifestations of upper gastrointestinal bleeding?