What to Expect When You're Hospitalized for a Severe UC Flare

Written by Sharon Liao
Medically Reviewed by Zilpah Sheikh, MD on February 19, 2026

If you have ulcerative colitis (UC), you know that symptoms, such as diarrhea, stomach cramps, and nausea, get worse during a flare. In some cases, they may become severe enough that you need to go to the hospital. There, doctors can monitor you closely and give you treatment right away.

Most patients stay in the hospital anywhere from three days to a few weeks for a severe ulcerative colitis flare, says Ekta Gupta, MD, chief of gastroenterology at the University of Maryland Medical Center Midtown Campus. Whether you or a loved one needs to go to the hospital, knowing what to expect can help you better prepare and ensure a smooth visit. Read on to learn what exactly happens during a hospital stay for a severe ulcerative colitis flare.

If your symptoms are potentially dangerous or life-threatening, you should go to the emergency room, Gupta says. Seek medical care if you have any of the following:

Excessive bleeding. Bloody stools are a common sign of ulcerative colitis. But if you notice an unusual amount of blood or if you have six or more bloody stools in a day, seek medical care right away.

Fever. Check with your doctor if you have a fever of 100.4 F or more, especially if it's ongoing and combined with other UC symptoms.

Severe dehydration. Diarrhea and vomiting can lead to dehydration. Seek medical attention if you have dark urine, fatigue, chills, or confusion.

Painful and expanded belly. These are signs of a rare but life-threatening condition called toxic megacolon, where the colon becomes severely inflamed.

Inability to eat or drink. If you can't keep down food, drinks, or medicine, you'll need to go to the hospital, Gupta says.

The purpose of a hospital stay is to stabilize your UC flare and ensure you have enough nutrition and hydration, says Maithili V. Chitnavis, MD, an associate professor of gastroenterology at Wake Forest University School of Medicine in Charlotte, North Carolina. Doctors will also want to rule out any potential complications, such as infections.

Once you're settled into your hospital room, you'll be assigned a team of nurses, doctors, and other medical staff. They'll introduce themselves and give you several tests. These include your vital signs and blood tests to check your vitamin and electrolyte levels. If you're deficient, nurses will give you an IV drip to replenish your fluids and any nutrients. 

You'll get blood tests to check your liver function, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR), two markers of inflammation. 

“Doctors look at CRP levels and ESR as a way to see how you're responding to treatment,” Gupta says. Stool tests are done to measure inflammation and screen for infections, such as one caused by C. difficile bacteria. 

In many cases, doctors will perform a flexible sigmoidoscopy, a minimally invasive procedure that examines the rectum and lower colon to assess the disease and rule out cytomegalovirus. This infection can’t be confirmed through blood or stool tests, Chitnavis says.

In the hospital, a team of health care professionals will work together to treat your severe ulcerative colitis flare. They include:

Nurses. They'll measure your vital signs, such as blood pressure and temperature, and provide day-to-day care.

Gastroenterologist. Most often, a gastroenterologist will oversee your care in the hospital, says Gupta. They specialize in digestive diseases. You'll meet with a gastroenterologist at least once a day to discuss your treatment.

Internal medicine or primary care doctor. This doctor will monitor your overall health and manage any other non-digestive issues that you may also have, says Chitnavis.

Dietitian. A dietitian can provide a nutritional plan to help you manage your UC. 

Depending on your needs, you may also get treated by these specialists:

Infectious diseases doctor. People with ulcerative colitis are more likely to get to viral and bacterial infections. These specialists can treat those infections.

Colorectal surgeon. In severe cases, a surgeon may need to remove part or all of the colon.

During your first three days of your hospital stay, doctors focus on getting your flare under control. The goal is stopping the severe inflammation triggered by the flare and putting the disease into remission. "The first treatment patients generally get is IV steroids," Chitnavis says. If you're diagnosed with an infection, you'll also receive medication, such as antibiotics, along with the steroids.

If you have a very serious case or if you don't get better with steroids, your doctor may prescribe another medicine to reduce the inflammation. These include the biologic medicine infliximab or the immunosuppressant cyclosporine.

At the hospital, the staff will closely monitor you. Every two to four hours, nurses will check your vital signs and check on your symptoms and bowel movements. At least once a day, usually in the morning, you'll meet with the gastroenterologist to discuss any test results and your treatment plan. "The doctor can answer any questions that you have," Gupta says.

The rest of the day, you'll meet with other specialists on your health care team, such as your dietitian or primary care doctor. If you need an infectious disease doctor or surgeon, you'll see them, too. "The rest of the time, you'll spend resting and waiting," Chitnavis says.

 

Your doctors will look at your CRP and ESR levels to see if your inflammation is improving, Gupta says. They'll factor in the results of your fecal calprotectin test, which also gauge inflammation in the intestines. They'll weigh those results along with improvements in your symptoms, such as no more rectal bleeding or stomach pain and fewer than four bowel movements a day. If your inflammation and symptoms have improved, your doctor may discharge you from the hospital so you can continue your care at home.

If your symptoms aren't improving, your health care team may recommend another treatment, such as biologic medicine or surgery. You may also need surgery to remove some or all of your colon if you're diagnosed with toxic megacolon, a life-threatening complication of ulcerative colitis. If possible, it's a good idea to have a friend or family member join you at the hospital, Chitnavis says. They can help filter through the information, provide support, and help with the decision-making process.

When you're ready to go home, you'll go over a discharge plan with your doctor. You'll transition from IV steroids to oral steroids that you can take home. "You need to have a gastroenterologist to follow up within two to three weeks," Chitnavis says. 

"Steroids are only used for a short period of time, because of the side effects." You'll need to work with your gastroenterologist on a medication and treatment plan that you can use long-term to keep your ulcerative colitis flares in check.

What about payment? Some hospitals offer a prepayment plan, but they're not usually required. Usually, it takes time for the hospital to coordinate payments between departments and from your insurance company. It can take weeks before you receive your final bill in the mail. If something doesn’t seem right, ask for a detailed bill and check the services. 

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