Ulcerative colitis can potentially lead to life-threatening complications. Knowing the risks and understanding when to seek emergency care is crucial.
Ulcerative colitis (UC), a type of inflammatory bowel disease (IBD), affects approximately 907,000 people in the United States. This chronic condition, characterised by inflammation of the colon, can lead to a range of complications that require careful management.
Although UC is not usually life-threatening, it is associated with various risks and complications. The chronic inflammation in UC can impair nutrient absorption, leading to deficiencies in key nutrients. Moreover, the inflammation and ulceration of the colon lining can cause bleeding and hemorrhage.
One of the most serious complications of UC is toxic megacolon, a condition where inflammation of the colon causes it to enlarge, potentially leading to a burst colon, sepsis, and shock. Symptoms of toxic megacolon include abdominal pain and swelling, frequent or bloody diarrhea, dehydration, rapid heart rate, fever, and signs of shock.
People with UC also have an increased risk of developing perforations in the colon, which can lead to peritonitis, inflammation of the peritoneum, the lining of the abdomen. Peritonitis can cause the abdomen to fill with fluid and lead to blood poisoning and sepsis, a whole-body inflammatory response to infection.
In addition to these localised bowel complications, UC patients have a significantly higher risk of developing arthritis and skin lesions, which are immune-related complications. They also face an increased risk of blood clot formation or thrombosis, with a risk up to three times higher than a person without IBD. Deep vein thrombosis (DVT) can occur when a blood clot blocks a vein in a limb, and a potentially fatal complication called a pulmonary embolism can occur when part of the clot breaks away and travels to the lungs.
A worrying aspect is the increased risk of colorectal cancer in UC patients. Between 5 and 8% of people with UC will develop colorectal cancer within 20 years of their diagnosis, linked to chronic inflammation and immune dysregulation. Colon cancer is the most common cause of death in UC.
Primary sclerosing cholangitis (PSC), a condition that involves inflammation and damage to the bile ducts, affects about 3% of people with IBD. PSC increases the risk of some potentially life-threatening complications such as variceal bleeding, ascites, hepatic encephalopathy, and hernias.
Despite these challenges, effective management of UC aims to prevent these serious outcomes. This includes regular check-ups with a gastroenterologist, colonoscopies every 1 to 2 years, taking prescribed medications, and maintaining a healthy lifestyle with regular exercise and a balanced diet. It is also crucial for UC patients to discuss their symptoms and concerns during regular check-ups, notify their doctor if a family member develops colorectal cancer, and be aware of the symptoms of DVT and pulmonary embolism.
In conclusion, UC involves both localised bowel complications and systemic risks, with immune dysregulation playing a central role in many of the disease’s manifestations. By understanding these risks and taking proactive steps to manage the condition, people with UC can lead fulfilling lives despite the challenges posed by the disease.
- Ulcerative colitis (UC) can impair nutrient absorption, leading to deficiencies in key nutrients due to chronic inflammation in the colon.
- The inflammation and ulceration of the colon lining in UC can cause bleeding and hemorrhage.
- Toxic megacolon, a serious complication of UC, can cause the colon to enlarge, potentially leading to a burst colon, sepsis, and shock.
- Perforations in the colon, a risk for UC patients, can lead to peritonitis, inflammation of the peritoneum, and blood poisoning.
- UC patients have an increased risk of developing arthritis, skin lesions, and blood clot formation or thrombosis.
- A significant risk for UC patients is the development of colorectal cancer, with between 5 and 8% developing it within 20 years of diagnosis, making it the most common cause of death in UC.
- Primary sclerosing cholangitis (PSC), affecting about 3% of people with IBD, increases the risk of life-threatening complications such as variceal bleeding, ascites, hepatic encephalopathy, and hernias.
- Effective management of UC involves regular check-ups with a gastroenterologist, colonoscopies, taking prescribed medications, maintaining a healthy lifestyle, discussing symptoms and concerns during regular check-ups, and being aware of symptoms of DVT and pulmonary embolism.
