While ulcerative colitis itself is not fatal, it is a chronic disease that needs to be properly managed to prevent serious health complications.

Ulcerative colitis (UC) is a lifelong condition that you need to manage. It’s not deadly on its own, but it is a serious disease that can cause some dangerous and potentially life threatening complications, especially if you don’t get the right treatment.

UC is one form of inflammatory bowel disease (IBD). It causes inflammation in the inner lining of your rectum and your large intestine (also known as your colon). The other type of IBD, Crohn’s disease, can affect any part of your digestive tract.

When you have UC, your immune system mistakenly attacks your intestines, and these attacks lead to inflammation and sores, or ulcers, in your intestines.

Treatments are available for UC. Most people with UC have a full life expectancy. However, according to one 2003 Danish study, complications can increase the risk of an early death.

While UC itself usually isn’t fatal, some of its complications can be.

Potentially serious health complications that can result from UC include:

The most serious possible complication related to UC is toxic megacolon, which is swelling of your colon that can cause it to rupture. This condition affects up to 10% of people with UC.

Some studies show that the death rate among people hospitalized with toxic megacolon is around 6.5%. However, the death rate drops to less than 2% in people with IBD who receive an early diagnosis and prompt medical care.

A hole in your bowel is also dangerous. Bacteria from your intestine can get into your abdomen and cause a potentially life threatening infection called peritonitis.

Primary sclerosing cholangitis is another rare but serious complication of UC. It causes swelling and damage around your liver and in your bile ducts, which carry digestive fluid from your liver to your intestines.

Scars can form and narrow your bile ducts, and this can eventually cause severe liver damage. In time, you can develop serious infections and liver failure. These conditions can be life threatening.

According to a 2001 research review, people with UC have up to an 8% chance of developing colorectal cancer within 20 years of their UC diagnosis. In comparison, the review noted that the risk among the larger population was 3% to 6%.

More recently, a 2023 review article noted that rates of colorectal cancer among people with UC are decreasing but are still higher than the rates in the larger population.

Colorectal cancer can be fatal if it spreads to other parts of your body.

According to a 2022 study, UC is associated with a greater risk of heart conditions, including coronary artery disease, heart failure, and atrial fibrillation. And a 2023 study suggests that people with IBD are at a higher risk of death from these types of heart conditions.

UC is a chronic condition that, for most people, requires lifelong treatment.

You’ll have periods of increased symptoms, known as flare-ups, followed by symptom-free periods called remissions. Some people go years without any symptoms, while others have flare-ups more often.

Overall, about 40% of people with UC will experience at least one flare-up each year.

You’ll have the best outlook if the inflammation is in only a small area of your colon. UC that spreads can be more severe and harder to treat.

Currently, the only way to cure UC is by having surgery to remove your colon and rectum. This is called proctocolectomy. Once your colon and rectum are removed, you’ll also have a lower risk for complications such as colon cancer.

You can improve your outlook by managing your UC and getting regular checkups to look for complications. Once you’ve had UC for about 8 years, you’ll also need to start having regular colonoscopies to screen for colon cancer.

Read this article in Spanish.

Tips

  • Take the medications your doctor has prescribed to manage your condition.
  • Have surgery if you need it.
  • Ask your doctor what screening tests you should get.
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