Ulcerative colitis (UC) is an inflammatory bowel disease that causes inflammation and ulcers to develop in the colon and rectum.

Currently, there is no cure for the disease other than surgical removal of the colon. But certain treatments and lifestyle changes can help ease symptoms. When receiving a diagnosis of UC, one of the hardest things to learn is that long-term medications and lifestyle changes might be necessary in order to enter UC remission. You may even try to avoid treatment for UC altogether, hoping symptoms will go away on their own.

If you’re struggling to decide whether or not to treat (or continue to treat) UC, it’s important for you to know the risks involved in leaving UC untreated.

Flare-ups can be very painful and often lead to bleeding, diarrhea, and abdominal cramps.

You may feel disappointed whenever you experience a flare-up, and while it’s easy to self-blame (e.g., that taco I ate, those drinks I had, that third coffee), it’s important to know that UC is unpredictable and flare-ups can come at any time. You might be doing everything right with your diet and lifestyle, and your UC can still cause you problems.

One way to manage UC flare-ups is to get medical treatment and be consistent about it. There are a variety of different drug therapies to manage flares, including anti-inflammatories, steroids, biologics, and immunosuppressants. Check with your doctor when trying to choose the right drug therapy for you.

People with UC are susceptible to dehydration and vitamin deficiencies, especially when not treating UC. The reason for this is because diarrhea can lead to significant water and nutrient loss in the body.

You may even feel like you can’t take in enough water or nutrients to stay hydrated and healthy. Some complications from UC-related dehydration and vitamin deficiencies are:

  • general fatigue
  • body aches
  • headaches
  • seizures
  • fever
  • urinary and kidney

Your doctor is there to help you develop strategies to avoid dehydration and vitamin deficiencies during a UC flare-up. To prevent this, you can try drinking a lot of water, avoiding caffeinated or carbonated drinks, and staying away from any prune or veggie juices. But sometimes these methods alone aren’t enough. Your doctor can recommend specific multivitamins that will help you stay hydrated and also boost your immune system.

A common symptom of UC is nausea. Not only is this uncomfortable, but it can often lead to other UC complications such as loss of appetite and weight loss. This domino effect can trigger a host of issues that can result in relapses and flare-ups.

Your doctor can help you develop an anti-nausea plan that involves a nutrient-rich, low-fiber diet. This plan will ensure you’re eating enough and keep nausea at bay. One strategy is to eat small, fist-size meals that are easily digestible. Pureed foods may also help you.

Some key foods and drinks to stay away from when you are feeling nauseous include:

  • nuts and seeds
  • beans
  • raw veggies
  • dairy
  • fried food
  • spicy food
  • alcohol
  • chocolate

If UC is left untreated, you may be at risk of developing other conditions. Some of these potential conditions include:

  • Arthritis or general joint pain. In the case of UC-related arthritis, joint pain tends to
    be limited to a few joints. With the proper diagnosis, a treatment plan that is
    complementary to your UC treatment can help immensely.
  • Liver damage. While
    rare, liver damage can become an issue if the liver becomes too inflamed or
    damaged. In most cases, the damage is reversible through treatment.
  • Osteoporosis.
    Untreated UC can cause severe vitamin D deficiencies. As a result, this can
    lead to osteoporosis. The risk is especially high for those with UC who are
    older. Vitamin supplements and diet changes can often greatly reduce this risk.
  • Colon cancer. People
    with UC are at a higher risk for this type of cancer. Studies
    have suggested a link between the amount of time someone has been diagnosed
    with UC and their likelihood of developing colon cancer. However, with frequent
    monitoring and testing, the risk for UC-related colon cancer decreases

Most treatment plans for UC actively consider the severity of your particular case. If you’re avoiding getting diagnosed or treating UC because you’re afraid or think your symptoms are “not that bad,” find a doctor you trust and check in with them. There are many treatment options available, so there really is little reason to avoid getting the help you deserve.

Gastroenterologists are doctors who specialize in helping people manage diseases that affect the gastrointestinal tract and liver. They can prescribe medications to reduce inflammation and control flare-ups. They can also use regular colonoscopies to screen you for colorectal cancers, which are a higher risk for people with UC.

Certain foods can trigger UC symptoms, such as cramping, diarrhea, and bloating. A dietitian can provide a personalized eating plan focused on nutrient-rich foods that are easy to digest. They can also help you find ways to reduce the risk of certain UC complications, such as malnutrition and nutrient deficiencies.

UC can increase your risk for iron deficiency (anemia). Hematologists specialize in treating blood conditions. They can check your iron levels and prescribe treatments, if necessary. They may recommend that you eat more iron-rich foods, take an oral supplement, or receive intravenous iron.

Living with UC can be stressful. The condition also increases the risk of depression, anxiety, and other mental health conditions. A psychologist, licensed professional counselor, or clinical social worker can diagnose mental health conditions and use psychotherapy to help you find ways to cope. A psychiatrist can prescribe medication, if necessary.

As many as 30 percent of people with UC may also have arthritis, an inflammatory condition that can cause swollen, painful joints. A rheumatologist can determine if you have arthritis and prescribe medication to manage your symptoms. This type of doctor specializes in treating arthritis and other musculoskeletal disorders.

Around 1 in 5 people with UC will need surgery at some point in their lives. A colorectal surgeon specializes in surgical treatments that involve the intestines, colon, and anus. They can explain the risks and benefits of UC surgeries, including proctocolectomy and ileal pouch-anal anastomosis (sometimes called J-pouch surgery), and perform procedures.

People with an inflammatory bowel disease are at greater risk of heart disease. Cardiologists specialize in treating heart conditions. They can screen you for signs of heart disease and prescribe medications, if necessary. They can also offer recommendations for making lifestyle changes, such as starting an exercise routine, that can reduce your risk of heart disease.