Ulcerative colitis is a type ofinflammatory bowel disease (IBD) that occurs when a person’s immune system attacks their intestines and digestive tract. This causesinflammation in the digestive tract, resulting in sores and ulcers in the large intestine or colon. UC affectsup to 900,000 people in the United States.

This article examines a person’s life expectancy, outlook, and potential risks and complications from UC.

Risks and complications

A person with UC may be more likely to develop certain health conditions. Some of these are less serious than others.

For example, some complications may include:

• Anemia: UC can make the body less efficient at storing iron. This canlead toiron-deficiency anemia.
• Bone health issues:Loss of bone density is relatively common in people with UC, affecting30–60% of those withCrohn’s disease or ulcerative colitis.
• Blood clots: UC increases a person’s risk ofblood clot formation. If a blood clot blocks a blood vessel in a limb, this can result indeep vein thrombosis, possibly leading to further complications such as apulmonary embolism.

Some more severe complications of UC include:

• Primary sclerosing cholangitis (PSC):PSC results from damage to the bile ducts due to inflammation. These ducts transport essential enzymes to the digestive system. Only people with severe UC are likely todevelop PSC.
• Toxic megacolon: Whilerare, the enlarging of the colon prevents it from contracting and pushing through digestive waste — doctors call thistoxic megacolon. The colon is then at risk of bursting, which releases harmful products into the bloodstream.
• Colorectal cancer: Having symptoms of UC forover 8 years can increase a person’s risk of developingcolon cancer, along with having PSC or a family history of colon cancer.
• Colon perforation: Long-term inflammation of the colon weakens the intestines. Weaknesses can perforate, letting in bacteria and allowing the colon’s contents to leak, causingperitonitis.

Treatment and management

UC is a long-term or chronic condition. The main aims of treatment involve managing episodes of symptoms andpreventing flare-ups. Below are treatment strategies for UC.

Medications

Mild symptoms of UC may be manageable with anti-inflammatory medications. This can includecorticosteroids, although doctors will only use these medications when necessary due to their side effects.

Severe symptoms of UC may require medications that block inflammation using antibodies. These arebiologic medications. In 2018, theFood and Drug Administration (FDA) approved the use oftofacitinib (Xeljanz) for treating UC.

Surgery

Surgery is typically only necessary in people with severe complications from UC.

For example, doctors may recommend surgical techniques if a person experiences:

• severe blood loss
• colon perforation
• severe blockages in the digestive tract
• symptoms that impact daily function

Surgery for UC typically involves removing the colon and rectum while creating a new pathway for waste to exit the body. This new route typically comprises a small opening in the abdomen called astoma.

Some surgeries leave the colon and rectum mostly intact but remove the areas with the most damage.

Read about the different surgical options and what to expect.

Natural remedies

Natural remedies cannot cure UC, but they help relieve symptoms alongside medical treatment.

For example, probiotics are living bacteria that a person can take as a supplement supporting gut function.

Astudy from 2019 notes how probiotics in 50% of a sample of people with UC improved their symptoms, such as stool frequency.

Outlook

Doctors do not consider UC a life threatening condition, and life expectancy is typical for most individuals.

However, complications secondary to UC can occur in20 to 30% of individuals and become severe and life threatening. People without complications have the best outlook.

Although there is no cure for UC, a person’s doctor can recommend different treatments to help prevent episodic symptoms. This can provide them with periods free from these symptoms.

Support for UC

Receiving a diagnosis of UC can be overwhelming, so a person must have access to the support they need.

A doctor will work with someone after a diagnosis of UC to develop the right treatment combinations for them.

Support groups are an effective way to learn more about a condition, and they can provide a person with a way of meeting others in a similar position. Support groups can take place online or in person.

Frequently asked questions

The following are the answers to some frequently asked questions about UC.

Does ulcerative colitis worsen with age?

UC can develop at any age, but doctors often diagnose it in people during their 30s.

The variation in age of onset means that UC presentsdifferently across these age groups. When a person receives a diagnosis at early onset, symptoms are typically more severe, with more inflammation across the body.

Symptoms at late onset are more likely due to environmental factors.

Is ulcerative colitis very serious?

Although UC is not fatal itself, the possible complications a person may experience can be.

Therefore, a doctor must monitor their condition regularly. Procedures, such as colon cancerscreening, can help prevent some of these more serious complications.

Can ulcerative colitis go away permanently?

There is no cure for UC, but the available treatment can help manage symptoms, calm inflammation, and increase remission periods between flare-ups.

Treatments are often a combination of methods to treat the different effects of the condition.

Summary

A person with UC will work with their doctor to monitor their condition and must follow a treatment plan throughout their life. Without complications, the life expectancy for a person with UC is typical.

Some complications, such as PSC, are life threatening. Also, at least5% of people with UC develop colon cancer in their lifetime, with this risk increasing over time.

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