Estimated reading time: 5 minutes
Medically reviewed and verified by Kate Burke, MD, MHA
As an autoimmune condition, ulcerative colitis (UC) can be difficult to manage. Chronic inflammation in the body will disrupt its natural rhythms and processes. Fortunately, there are several ways to treat UC and live a life unrestricted by this condition. If left untreated, however, UC can cause a number of serious health complications. These issues tend to develop over time and do not develop suddenly. This means you usually have a window to work with your doctor and find solutions should side effects arise. Understanding what could happen is the best way to prepare yourself for the potential risks. Here, PatientsLikeMe will explain the most common health complications that happen if UC is left untreated.
Ulcers
The main issue with UC is the development of ulcers in the colon. These painful sores cause symptoms like bloody diarrhea and abdominal pain. If ulcers become severe, they can weaken the wall of the colon. This can lead to a rupture in the colon, which could lead to the contents of the intestine leaking into the abdomen. This leakage can cause a serious infection called peritonitis, which is life-threatening and needs immediate medical attention.
Fulminant Colitis
This is a severe but rare form of UC. It affects fewer than 10% of people with the condition, but if it does develop requires immediate medical attention. Fulminant colitis often starts after an infection in the GI tract. This leads to increased inflammation in the colon. As the walls of the colon swell, it is possible to develop a perforation which can be life-threatening. Symptoms may include abdominal pain, bloating, bloody stool, weight loss, and more than 10 bowel movements a day.
Toxic Megacolon
This is another rare but life-threatening condition. Toxic megacolon is a serious complication where the colon becomes very swollen. The inflammation causes the muscles in the colon to stop working, which allows food and gas to build up inside. As the walls of the colon stretch, toxins can start leaking into your bloodstream. This can lead to a high fever, rapid heart rate, severe belly pain, and diarrhea. If not treated promptly, toxic megacolon can cause the colon to rupture, which can be fatal.
Colorectal Cancer
Unfortunately, people with UC are six times more likely to develop colorectal cancer (CRC). The longer you have UC, the greater the risk. The cumulative risk of RCR increases with the duration of the UC: 2% by 10 years, 8% by 20 years, and 18% by 30 years. The chronic inflammation caused by UC damaged the colon lining and destroys cells meant for repair. Over time, the likelihood that this damage will happen to the DNA in your colon cells increases. UC also makes you more prone to infection, which can help cancer cells multiply. Regular screening is important for early detection and treatment of colorectal cancer.
Fatigue
Chronic inflammation in the body can make you feel tired all the time. This fatigue is usually a result of other symptoms that your body must deal with. Nausea or a loss of appetite means your body could be low on fuel. Diarrhea leaves you dehydrated, and swelling in the colon means your body isn't absorbing all the nutrients it needs. If you are waking up at night to go to the bathroom, you might not be getting enough sleep. All these things together can cause fatigue!
Weakened Immune System
Ulcerative colitis is an autoimmune disease, meaning those who develop the condition already have a weakened immune system. Unfortunately, developing UC can cause something of a feedback loop. Chronic inflammation can weaken your immune system, making you more susceptible to other infections and other illnesses.
Osteoporosis
Between 30-60% of people with IBD (which includes both Crohn's and UC) have lower-than-average bone density. This does happen more often in Crohn's but can affect those with UC. Certain anti-inflammatory medications called corticosteroids may be prescribed for treating UC. These medications can lead to osteoporosis by decreasing the amount of calcium your intestines absorb and decreasing the number of bone-forming cells. Inflammation can also raise the levels of certain proteins in your body. These proteins can disrupt bone metabolism.
Complications During Pregnancy
People with UC are at a higher risk of certain pregnancy and delivery complications. UC can lead to miscarriage, preterm delivery, preeclampsia, and a low birth weight. Generally, doctors will recommend you try to conceive while your UC is in remission. However, most UC medications are safe to take during pregnancy and with careful monitoring you can have a safe and healthy pregnancy.
Untreated ulcerative colitis can lead to serious health problems, some of which can be life-threatening. The good news is that with proper treatment inflammation can be controlled, and many of these complications can be prevented. If you have UC, working closely with your doctor is essential for maintaining your health and quality of life.
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