What Happens
The course of
ulcerative colitis varies greatly from one person to
another. Some people may have only mild symptoms, and others may have severe
symptoms or complications that, in unusual cases, may be
life-threatening.
Ulcerative colitis may be
mild, moderate, or severe. It may be described as dependent on
corticosteroids, unresponsive to steroids, or not
active (in remission).
Ulcerative colitis
also may be defined by the part of the large
intestine affected: the rectum (proctitis), the left side of the colon
(left-sided colitis), or the entire colon (pancolitis).
Most
people with ulcerative colitis have periods of remission that may last up to
several years. These periods are interrupted by occasional flare-ups of
moderate symptoms. About 5 to 10 out of 100 people who have ulcerative colitis
have symptoms all the time.1
Children may
have the same symptoms as adults. Also, children with ulcerative colitis may
grow more slowly than normal and go through puberty later than expected.
Complications and long-term effects
- Inflammation and scarring of the bile ducts
(primary sclerosing cholangitis) may occur. A bile duct is a passage that
carries fluid produced in the liver to the small intestine.
- Severe
inflammation and ulceration sometimes irritate muscles in the colon, causing
colon walls to stretch. The colon may swell to many times its normal size, a
condition known as
toxic megacolon. This is an emergency that requires
immediate treatment, but it is rare.
- Narrowed areas of the
intestine (strictures) may occur in ulcerative colitis, causing difficulty in
passing stools. Abnormal connections or openings (fistulas) between parts of the intestine or between
the intestine and other organs are rare because ulcerative colitis does not
affect the deeper intestinal tissues.
- Your
risk of cancer of the colon and rectum is higher than average if you have had
ulcerative colitis for 8 years or longer. With regular screening, some cancers
can be detected early and treated successfully.
- Ulcerative colitis can cause rare complications such as
scarring of the
pancreas and inflammation of the membrane surrounding
the heart (pericarditis).
Some people who have ulcerative colitis also have
irritable bowel syndrome (IBS), which is not as
serious as ulcerative colitis. IBS causes abdominal pain along with diarrhea or
constipation.
Most women who have ulcerative colitis are able to
become pregnant and usually have healthy babies. Symptoms may become worse
during the first 3 months of
pregnancy. Some medicines to treat the disease can be
used during pregnancy.