Ulcerative Colitis and Urgency: What’s Normal and What You Can Do About It
Health ConditionsDigestive HealthUlcerative Colitis

Ulcerative Colitis and Urgency: What You Can Do About It

Ulcerative Colitis and Urgency: What You Can Do About It
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Published on February 24, 2026
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More than 80 percent of people with ulcerative colitis (UC) experience bowel urgency — that overwhelming, need-to-use-the-bathroom-right-now sensation.

 And for many, it’s one of the toughest parts of living with UC.

“Urgency is one of the more debilitating symptoms that people with UC experience,” says John Haydek, MD, an assistant professor of medicine in the division of gastroenterology and hepatology at the University of North Carolina School of Medicine in Chapel Hill. “It can sometimes lead people to not want to leave the house, go to dinner with friends, or go on vacation.”

Adding to the problem is the fact that urgency often goes unacknowledged, both by doctors and people living with the condition. Thankfully, there are ways to manage this unpleasant symptom.

Why Urgency Happens in UC

Urgency is the sudden feeling that you need to have a bowel movement ASAP. That’s different from incontinence, which is not making it to the bathroom in time.

Experts don’t fully understand why people with UC have urgency. Most likely, it’s due to a combination of factors, including ongoing colon and rectal inflammation, which can make you hypersensitive to the need to have a bowel movement, or nerve and muscle damage around the anus.

 Many people with UC also have overlapping gut-brain function disorders, such as irritable bowel syndrome, which can exacerbate urgency symptoms.

Urgency can strike during a flare, as well as when you’re in remission. Most people with UC will deal with urgency at some point, but you may be especially prone if you:

  • Have severe UC
  • Have had UC for more than 15 years
  • Have a J-pouch, proctitis, or perianal fistulas
  • Are older

4 Solutions for UC Urgency

There are things you can do to better control urgency, so it doesn’t control you.

1. Track Eating Habits

Keep a food diary to track whether certain foods cause urgency or make it worse. Some people with UC find that symptoms are triggered by:

  • Alcohol
  • Caffeine
  • Certain high-fiber foods, such as cruciferous vegetables like broccoli or Brussels sprouts; nuts and seeds; raw leafy greens; and skin-on fruit
  • Dairy, such as milk, ice cream, and cheese
  • Large or fatty meals
  • Spicy foods
  • Sugar alcohols and artificial sweeteners

If you’re having trouble identifying problem foods and finding good alternatives, try working with a registered dietitian who specializes in inflammatory bowel disease.

This will help you define your personal triggers, since what causes urgency for one person might actually help someone else. For example, some people find that extra fiber can actually be beneficial when they’re in remission. “For patients who struggle with urgency, particularly those with UC under good control, I recommend the addition of dietary fiber to bulk the stool,” says Dr. Haydek. Foods rich in soluble fiber — for example, barley, lentils, oat bran, and peas — are an especially good choice, because this type of fiber can help slow down digestion.

2. Manage Stress

Your brain and gut are directly connected, which is why anxiety and stress can make urgency worse.

 Find relaxation strategies you enjoy and can do regularly, whether it’s deep breathing, journaling, moderate exercise, or yoga.

3. Try Pelvic Floor Therapy

Your pelvic floor is a hammock-shaped group of muscles that support your bowel and bladder and help control when you defecate or urinate. Certain exercises can help make your pelvic floor muscles stronger, which may make it easier to manage urgency and incontinence.

 It’s best to learn these exercises from a pelvic floor therapist, who can teach you how to do them correctly.

4. Consider Bowel Retraining

Bowel retraining helps you establish a regular, predictable pattern for when you’ll go to the bathroom, which can help cut down on unexpected trips. It involves sitting on the toilet at the same time(s) each day and completely emptying your bowels. Talk to your gastroenterologist about how to put this strategy into practice.

When Urgency Is a Bigger Problem

Let your gastroenterologist know if you have new or worsening urgency or feel like urgency could be better controlled. “Patients should not feel embarrassed or ashamed to talk about it,” says Haydek.

Contact your gastroenterologist, too, if the urgency is accompanied by other new or worsening symptoms, such as abdominal cramps or pain, bloody stool, fatigue, lack of appetite, persistent diarrhea, or weight loss. These could be signs of a flare and should be treated as quickly as possible.

The Takeaway

  • Bowel urgency is common with ulcerative colitis and can seriously disrupt daily life. It can happen during flares or remission and may be more likely in people with severe or long-standing UC.
  • Stress management, pelvic floor therapy, diet tweaks, and bowel retraining can help improve control. Your gastroenterologist can help come up with a plan that works for you.
  • Seek help for new or worsening urgency. This is especially true if it’s accompanied by an increase in other UC symptoms.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Pakpoor J et al. Why Studying Urgency Is Urgent. Gastroenterology & Hepatology. February 2023.
  2. Nigam GB et al. Fecal Urgency in Ulcerative Colitis: Impact on Quality of Life and Psychological Well-Being in Active and Inactive Disease States. Clinical Gastroenterology & Hepatology. August 2024.
  3. Gershon MD et al. The Gut, Its Microbiome, and the Brain: Connections and Communications. The Journal of Clinical Investigation. September 15, 2021.
  4. Khera AJ et al. Systematic Review: Pelvic Floor Muscle Training for Functional Bowel Symptoms in Inflammatory Bowel Disease. JGH Open. December 2019.
Additional Sources
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Yuying Luo, MD

Medical Reviewer

Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.

Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.

She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.

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Marygrace Taylor

Marygrace Taylor

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Marygrace Taylor is an award-winning freelance health and wellness writer with more than 15 years of experience covering topics including women’s health, nutrition, chronic conditions, and preventive medicine. Her work has appeared in top national outlets like Prevention, Parade, Women’s Health, and O, The Oprah Magazine.

She's also the coauthor of three books: Eat Clean, Stay Lean: The Diet, Prevention Mediterranean Table, and Allergy-Friendly Food for Families. She lives in Philadelphia.

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