What Is the Life Expectancy of Someone With Ulcerative Colitis?

Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that affects the inner lining of the large intestine (large bowel) leading to erosion and ulcers. It is a lifelong illness with no specific cause or cure. Patients have repeated cycles of flare-ups and remission with potential extraintestinal manifestations. There is a profound emotional and social impact on the affected patients.

The exact cause of ulcerative colitis (UC) is unknown. However, research has revealed some possible causes for the disease: 

• Genetics:
• Immune reactions:
  • The body’s immune system attacks the inner lining of the large intestine (an autoimmune disorder).
• Environmental factors:
  • Diet containing high fat, sulfur and high quantity of meat
  • Certain medication
  • Alcohol and substance abuse
  • Psychological stress
• Medications:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of UC.
• Milk:
  • Consumption may flare up the disease.

The signs and symptoms of ulcerative colitis (UC) are as follows:

1. Rectal bleeding
2. Frequent stools
3. Mucous discharge from the rectum
4. Tenesmus (constantly feeling the need to empty the bowels)
5. Lower abdominal pain and cramps
6. Dehydration 
7. Severe diarrhea 
8. Fever
9. Abdominal distention/bloating
10. Increased heart rate
11. Weight loss
12. Pus discharge through the anus
13. Extracolonic manifestations (inflammation of the eyes, joints, skin, and lungs)

There are five different types of ulcerative colitis.

• Ulcerative proctitis: Inflammation limited to the area close to the anus (rectum). Symptoms are usually mild, and rectal bleeding may be the only sign.
• Proctosigmoiditis: Inflammation involves the lower end of the colon
• Left-sided colitis: Inflammation extends from the rectum up through the sigmoid and descending colon
• Pancolitis: Involves the entire colon
• Acute severe ulcerative colitis (UC): This rare form of colitis affects the entire colon and causes severe pain, profuse diarrhea, bleeding, fever, and inability to eat.

The severity of UC can be graded as follows:

• Mild: Bleeding through the rectum and fewer than four bowel motions per day
• Moderate: Bleeding through the rectum with more than four bowel motions per day
• Severe: Bleeding through the rectum more than four bowel motions per day and a widespread (systemic) illness with protein loss

The physician would do a complete physical assessment, advice a series of specialized blood and radiological investigations (X-ray, computed tomography [CT] scan, etc.). Colonoscopy, endoscopy, biopsy, stool examination, and other tests may be done.

Ulcerative colitis (UC) is a lifelong disease with constant periods of flare-ups and remission (relief in symptoms). Presently, there is no permanent medical cure for it, but there are various medications that can provide symptomatic relief, reduce inflammation, and manage flare-ups.

Treatment involves medical and surgical management depending on the disease severity. Patients would also require dietary and lifestyle changes.

• Medical treatment includes the following:
  • Medication to suppress and/or modulate the immune system
  • Painkillers
  • Antibiotics
  • Anti-diarrhea medication
• Surgical treatment includes the following:
  • Colectomy (surgical removal of part of the colon or whole colon) may be required in severe cases.
• Dietary changes:
  • Diet low in fat, meat, sulfur and milk
• Management of psychological stress and emotional support

The possible complications of ulcerative colitis are as follows:

• Bleeding: The ulcers and erosions in the inner lining of the large intestine can perforate through the layers of the intestine causing bleeding. 
• Nutrition loss and dehydration: Chronic diarrhea and inflammation lead to dehydration, nutrition loss, and a decrease in the absorption of nutrients.
• Inflammation of other organs: Inflammation of the eyes, joints, skin, liver, and lungs
• Toxic megacolon: A rare complication that causes swelling and ballooning of the colon manifesting as:
  • Swollen and painful abdomen
  • Diarrhea
  • Palpitations
  • Fever
• Colon cancer and ulcerative colitis (UC): The chances of colon cancer increase if the patient has had UC for over eight years. Appropriate treatment and the availability of new treatment options for UC have lowered the risk of colon cancer.