Ulcerative colitis is a long-term condition that affects the bowels. Without treatment, symptoms can worsen, leading to complications such as fatigue, nutritional deficiencies, and weight loss.

Ulcerative colitis is a type of inflammatory bowel disease. In people with ulcerative colitis, an overactive immune system attacks the colon’s lining, causing ulcers and inflammation. Symptoms typically include:

  • frequent diarrhea
  • abdominal pain and cramps
  • bloody stools

These symptoms can range from mild to severe. They tend to come and go in cycles.

When a person has few or no symptoms, doctors refer to the condition as being in remission. When symptoms suddenly get worse, they call it a flare-up.

In this article, we discuss the potential complications of not treating ulcerative colitis and whether a person can die from this condition.

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Ulcerative colitis tends to be a progressive condition that does not get better.

Symptoms may persist and worsen without treatment. Inflammation may spread within the colon. With every flare-up, there is a risk of further damage to the colon’s lining. This can make it harder for a person to manage the condition in the future.

In children, not treating ulcerative colitis can limit their growth and interfere with overall development.

If people do not treat ulcerative colitis, it may lead to:

  • nutritional deficiencies
  • loss of appetite
  • swollen abdomen
  • fatigue
  • unintended weight loss
  • anemia
  • fever
  • rapid heart rate
  • bleeding from the rectum
  • ruptured bowel
  • greater risk of colon cancer

Ulcerative colitis may also increase the risk of physical and mental health complications, such as:

  • arthritis
  • skin problems
  • eye inflammation
  • liver and kidney problems
  • bone loss
  • stress
  • depression

The only cure for ulcerative colitis involves surgically removing the colon. However, medications and diet can relieve symptoms, slow progression, and help the condition stay in remission for longer.

The earlier a person begins treatment, the more effective treatment is likely to be.

For people with severe ulcerative colitis, prompt treatment can help prevent complications, such as an increased risk of developing colorectal cancer. Prompt treatment can also decrease the need for colectomy (colon resection).

The risk of developing cancer increases in people with severe ulcerative colitis and in those who have had the disease for longer.

According to a 2016 research article, improvements in treatment mean that mortality rates are no higher for people with ulcerative colitis than they are for people without the condition.

Acute severe colitis is a serious complication of ulcerative colitis that can be life threatening. Research indicates that it affects around 25% of people with ulcerative colitis.

Anyone with symptoms of ulcerative colitis should talk with a medical professional for an evaluation.

Individuals who already have a diagnosis of ulcerative colitis should talk with a doctor if symptoms worsen. This development could signify a flare-up. Appropriate treatment can help control inflammation.

People may want to seek emergency assistance if symptoms are sudden and severe.

Doctors can prescribe a range of medications to treat ulcerative colitis. Treatment aims to relieve symptoms and induce and maintain remission.

Available treatment options for ulcerative colitis can include:

  • Antidiarrheal medications: These can help reduce or stop diarrhea but are usually for short-term use.
  • Aminosalicylates: This class of drugs can help control inflammation in people with mild to moderate symptoms.
  • Corticosteroids: Doctors often prescribe these for short-term relief of more severe symptoms and to induce remission.
  • Immunomodulators: These drugs suppress the immune system to help reduce inflammation in the colon. An immunomodulator might be necessary if treatment with an aminosalicylate is not working.
  • Biologics: These are antibodies that target specific parts of the immune system. In moderate to severe cases of ulcerative colitis, biologics are a first-line therapy and can help slow or stop disease progression.
  • Dietary supplements: Supplements can help address anemia and other nutritional deficiencies.
  • Antibiotics: Infected abscesses and ulcers may require a course of antibiotics if untreated ulcerative colitis has caused them to occur.
  • Surgery: A healthcare professional may recommend surgery for people with severe or difficult to treat ulcerative colitis. This can involve removing part or all of a person’s colon.

Lifestyle changes and strategies may also help a person better manage their ulcerative colitis. For instance, research suggests that a low fat diet that prioritizes vegetables may reduce the risk of developing ulcerative colitis.

Lifestyle modifications that may help a person manage their symptoms include:

  • drinking more liquids but avoiding sodas and other fizzy drinks
  • replacing large meals with smaller, more frequent ones
  • using a journal to track foods that may trigger flare-ups
  • limiting high fiber and high fat foods during flare-ups

Ulcerative colitis is a long-term disease that can vary in its symptoms and severity. Medications and diet can help relieve symptoms, maintain remission, and slow progression. The only cure for ulcerative colitis involves the surgical removal of the entire colon.

If left untreated, symptoms of ulcerative colitis can worsen and may become more challenging to treat in the future. Successful treatment also reduces a person’s risk of developing severe and potentially life threatening complications.