Ulcerative Colitis Complications and Prognosis

Medically Reviewed by Minesh Khatri, MD on April 09, 2023
Written by Keri Wiginton
4 min read

If you have ulcerative colitis (UC), your life expectancy is pretty much the same as someone without it. Getting the right medical care is the key to preventing complications, including some that could be life-threatening.

Medicine, changes to your diet, and surgery can help you stay well. Make sure you keep in touch with your doctor. If your symptoms come back, they can help you find new ways to control your disease. That will lower your chances of getting really sick from UC.

Ulcerative colitis, a disease that causes inflammation and sores in the digestive tract, affects everyone in a different way. About 10% of people get better after one attack, but it's more likely that you'll have flares that come and go throughout your life.

You may go weeks or years without any symptoms. That's called remission. The longer you go without a flare, the better your overall health will be.

Your doctor will likely give you medicine to control inflammation and other symptoms.

If you don't feel like your UC is under control, talk to your doctor. They may want to change your medicine dose or switch you to a different drug. If that doesn't work, you may need surgery.

When you have ulcerative colitis, you may be more likely to get colon cancer. Your chances go up if you don't get treatment for UC. That's because unchecked inflammation can cause changes in the cells in your colon. These cells may turn into cancer down the road.

Your chances of getting colon cancer go up if you've had ulcerative colitis for 8 years or longer. The odds are also higher if:

Some research shows that people with UC may be less likely to get colon cancer now than in the past. Experts think it's because doctors now have better ways to screen for colon cancer and they do it more often. It also helps that new medicines, like biologics, do a good job of curbing inflammation.

You may never have any serious problems. But it's important to know what might happen if your UC isn't controlled. You might get:

Bleeding. Ulcers on your intestines can open up and bleed. If you lose a lot of blood, you might get anemia. That's a loss of red blood cells, or hemoglobin. Tell your doctor if you notice blood in your stool or if you feel very tired.

Dehydration and nutrient loss. UC can cause diarrhea and inflammation. That means you may not absorb the fluids an minerals you need. In serious cases, you may need to go to the hospital. You may need to get water and nutrients through a vein in your arm.

Inflammation. Since your immune system, the body's defense against germs doesn't work right when you have UC, you may get inflammation in other parts of your body besides the digestive tract. That includes your joints, eyes, skin, or organs like your liver.

Inflammation in the joints can be painful. Beyond joint pain, up to 30% of people with inflammatory bowel disease (IBD) develop some form of arthritis.

It’s not common, but some people with IBD develop inflamed bile ducts in their liver.

Perforated bowel. This means that there’s a hole in your bowel. It can happen due to long-term inflammation.

Eye problems. About 1 in 10 people with inflammatory bowel disease (which includes ulcerative colitis and Crohn’s disease) develop eye problems, some of which are related to inflammation. These include uveitis and episcleritis, which refer to inflammation in specific parts of the eye, and dry eyes.

Skin problems. Up to 20% of people with IBD develop skin problems. The more likely ones for people with ulcerative colitis include:

  • Erythema nodosum: tender red bumps, usually on the skin of the ankles or shins. They’re more likely during a flare.
  • Pyoderma gangrenosum: blisters that are typically on the shins or ankles.

Toxic megacolon. It's rare, but your colon can swell up. That's because inflammation can get inside your tissue. Get help right away if you think you have megacolon. It's life-threatening and needs fast treatment. You could go into shock. If that happens, you'll have a weak pulse and you may breathe fast.

Here are some other signs of megacolon:

Keep up with treatment even when you're in remission. That means you need to take your medicine even if you feel good. See your doctor at least once a year so they can see how things are going. And like everyone else, it's important to stay active and follow a healthy diet.

Get regular screenings for colon cancer. Your doctor will let you know how often you should get checked. You may need a colonoscopy every 1-3 years. That's a procedure that helps your doctor look for cancer or cells that might become dangerous. Your chances of recovery go way up when you find and treat colon cancer early.