Treatment can help prevent some of these serious complications.
Like many other types of autoimmune diseases, ulcerative colitis can cause serious complications if it goes untreated. That’s because it creates chronic inflammation in the body, which can have numerous effects on your health. Some of the complications can actually be life-threatening emergencies.
The good news is that treatment for ulcerative colitis can control the inflammation and prevent these complications. It can help you achieve and maintain remission—when disease activity is low and symptoms are minimal. The better you can stay in remission, the lower your risk of complications, and the higher your quality of life will be.
Risks of Untreated Ulcerative Colitis
A common issue with UC is ulcers in the colon—which is where ulcerative colitis gets its name. These are painful sores in the lining of the colon. This is often what causes common UC symptoms like bloody diarrhea and abdominal pain.
If the condition worsens and ulcers become more severe, they may weaken the wall of the colon and develop a connection to other parts of your organs, or create a rupture (hole). Obviously, a hole in any organ is not ideal. A rupture in the colon can allow contents of the intestine to leak into the rest of the abdomen. Even worse, this can lead to a serious infection.
Another risk of untreated ulcerative colitis is fulminant colitis. This is a severe form of UC in which you might experience high fever, stomach pain, and more than 10 bloody bowel movements a day. This is a medical emergency, and you should seek care immediately.
Another emergency complication is called toxic megacolon. As the name suggests, this is when the colon dilates and expands significantly. As a result, the large intestine can no longer function as normal, and you may also have high fever, increased heart rate, abdominal distension, dehydration, and low blood pressure, among other symptoms.
The Risk of Cancer
Finally, ulcerative colitis (and Crohn’s disease) can increase the risk of developing colorectal cancer. About five to eight percent of people with UC will develop this cancer within two decades of their diagnosis, according to the Crohn’s and Colitis Foundation.
The risk of colorectal cancer is higher for people who have:
- Disease activity in all sections of the large intestine (known as pancolitis)
- More severe inflammation
- A history of colon polyps
- A family history of colorectal cancer
People with ulcerative colitis should talk to their doctor about colorectal screening. Depending on your risk factors, your doctor may suggest screening earlier and/or more frequently than the general population. This can help catch colorectal cancer early, when it’s easier to treat.
Sticking to your treatment and visiting with your doctor regularly are some of the best things you can do to reduce your risk of complications. Together, you and your doctor can find the treatment that works best for you, and monitor your condition to catch any potential complications early.
Dr. Kayal is a gastroenterologist at Icahn School of Medicine at Mount Sinai.
- Management of moderate to severe ulcerative colitis in adults. Waltham, MA: UpToDate, 2021. (Accessed on June 15, 2021)
- Fact sheet. Crohn’s and Colitis Foundation. (Accessed on June 15, 2021)
- Toxic megacolon. Waltham, MA: UpToDate, 2021. (Accessed on June 15, 2021)
- Ulcerative colitis. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed on June 15, 2021)