Complications of Ulcerative Colitis
The complications that ulcerative colitis patients experience depend on the severity of the disease. Some complications can be life threatening, while others are manageable with the help of treatment plans prescribed by a gastroenterologist.
Complications can include:
- Bleeding: Rectal bleeding and bloody diarrhea are two of the hallmark symptoms of ulcerative colitis.
- Anemia: In ulcerative colitis, this is usually the result of chronic blood loss. To combat anemia, gastroenterologists often prescribe supplements, and recommend a diet rich in iron.
- Malnutrition: Symptoms such as diarrhea and rectal bleeding can lead to a loss of fluids and nutrients.
- Growth retardation: In children with ulcerative colitis, a combination of factors, including malnutrition and the use of corticosteroid treatment, may contribute to growth retardation.
- Osteoporosis: Ulcerative colitis patients are at risk for low bone density, chiefly due to long-term use of some medications, such as steroids.
- Strictures: Abnormal narrowing of the intestine.
- Obstruction: Swelling and scarring obstructing the intestine.
- Hospitalization: Occurs when symptoms are too severe to control with medication. Hospitalization is required to stop diarrhea, loss of fluids, blood, or nutrients. In some cases, surgery may be required at this point.
- Surgery: Ulcerative colitis patients may undergo surgery to treat various complications of their disease. Currently, 25-40% of ulcerative colitis patients eventually have their colons removed through a procedure known as a colectomy.
- Colon cancer: Ulcerative colitis patients have a higher risk of developing colon cancer. The risk increases when a greater proportion of the colon is affected, or if a patient has had ulcerative colitis for a prolonged period of time. Gastroenterologists may recommend that certain ulcerative colitis patients undergo periodic screening for colon cancer, based on disease duration.
- Perforation: Extensive inflammation can lead to a tear in the intestinal wall, resulting in leakage of bowel contents outside the intestine. Categorized by sudden, severe abdominal pain, shock, and excessive abdominal tenderness, this condition usually requires emergency surgery.
- Toxic megacolon: This serious complication may occur when inflammation spreads from the lining of the colon to involve the entire intestinal wall. Because this involvement temporarily stops the normal contractile movements of the intestine, the large intestine may greatly expand. The person is usually severely ill with fever, abdominal pain and distension. Immediate and aggressive measures are required to minimize risk of death.
- Extraintestinal manifestations: Ulcerative colitis may be associated with a number of complications outside the intestine. These include:
- Inflammation of the eye, which can cause redness and pain and, rarely, lead to vision loss.
- Skin disorders where painful nodules or deep ulcers may develop on the skin.
- Arthritis, which may involve the large joints (e.g., knee) or the spine. Spinal involvement may include a disease called ankylosing spondylitis, which is an important cause of disability.
- Increased risk for certain liver disorders, such as scarring of the bile ducts, which can lead to liver failure and liver transplantation.
Currently, there is no drug that cures ulcerative colitis. In the meantime, the goals of treating ulcerative colitis are to
control symptoms by reducing inflammation, achieving symptom remission, healing the intestine (or mucosa), reducing or stopping steroid use, and reducing the need for surgery.
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