Which clinical sign would most clearly indicate improvement in ulcerative colitis after therapy begins?

• A. Decreased diarrhea
• B. Increased fever
• C. Worsening abdominal tenderness
• D. Weight loss

Answer: (A)

The key idea is that treatment for ulcerative colitis aims to quell the mucosal inflammation, and the clearest sign this is happening is a drop in stool frequency. When inflammation improves, the colon’s ability to absorb water and electrolytes returns toward normal, so bowel movements lessen in number and urgency, reflecting better disease control. Fever would suggest ongoing systemic inflammation or a complication and is not a direct or immediate sign of mucosal healing. Worsening abdominal tenderness indicates ongoing disease activity rather than improvement, and weight loss can improve later but is less specific and slower to respond than changes in diarrhea. Therefore, a decrease in diarrhea best signals that therapy is effective.