What happens if ulcerative colitis (UC) goes untreated?

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.
Untreated ulcerative colitis
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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
Why is treatment important?
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.
more effective
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).
increased risk
The risk of developing cancer increases in people with severe ulcerative colitis and in those who have had the disease for longer.
Can you die from ulcerative colitis?
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.
2016 research article
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.
When to see a doctor
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.
Treatment options
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.
research
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
Summary
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.
Read the article in Spanish.
Read the article in Spanish.