Complications
Surgical removal of the colon is the only cure for ulcerative colitis, but the disease varies greatly in severity. In one 10-year study, 87% of patients went into complete remission after a single attack, and only 8% developed a chronic persistent condition. Mortality rates were about the same as in the general population, although they were higher in patients with UC with severe initial attacks or extensive disease. Surgical and medical treatments have complications of their own that can be very severe.
Criteria for Severity of Ulcerative Colitis
Ulcerative colitis is considered mild if a patient has the following symptoms:
- Four or less bowel movements a day
- Only occasional blood in the stool
- A normal temperature and pulse rate
- Normal hemoglobin or red blood cell count
- No abnormalities observed on x-rays of the colon.
Ulcerative colitis is considered serious if the following symptoms are present:
- More than six movements a day
- Frequent to persistent blood and mucus in the stool (in serious cases, stool is liquid and looks like anchovy sauce)
- Fever
- A rapid pulse
- Anemia
- Abnormal x-rays of the colon
- Tenderness in the abdomen when pressed, with possible distention
Complications in the Intestine
Malabsorption and Malnutrition. Malabsorption is the inability of the intestines to absorb nutrients. In IBD, this occurs as a result of bleeding and diarrhea, as a side effect from some of the medications, and as a result of surgery. Malnutrition typically develops rapidly after the condition has been present for some time.
Toxic Megacolon. Toxic megacolon is a serious complication that can occur if inflammation spreads into the deeper layers of the colon. In such cases, the colon enlarges and becomes paralyzed. In severe cases, it may rupture, which is a life-threatening event and requires emergency surgery. Symptoms include weakness and abdominal pain and bloating. You may be disoriented or groggy. X-rays are needed to confirm the diagnosis, but barium enemas and colonoscopies should not be performed. Medications used for pain and diarrhea, such as opiates and drugs that reduce spasms of the colon, may increase the risk of toxic megacolon. People with UC have a higher than normal risk, although this is still an uncommon occurrence. Its incidence is decreasing with treatment advances.
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