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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Bhupinder Anand, MD

Treatment for ulcerative colitis depends on the severity of the disease. Most people are treated with medication. If there is significant bleeding, infection, or complications, surgery may be required to remove the diseased colon. Surgery is the only cure for ulcerative colitis.

Ulcerative colitis may affect patients in different ways, and treatment is adjusted to meet the needs of the specific patient. Emotional and psychological support is also important.

The symptoms of ulcerative colitis come and go. Periods of remission, in which symptoms resolve, may last for months or years before relapsing. Patients and physicians need to decide together whether medications will be continued during remission times. In some patients, it may be the case that the medications keep the disease under control, and stopping them will cause a relapse.

Ulcerative colitis is a lifelong illness and cannot be ignored. Routine medical check-ups are necessary and scheduled colonoscopies are important to monitor the health of the patient and to make certain that the ulcerative colitis is under control and not spreading.

• Significant complications may occur with an acute flare of ulcerative colitis including dehydration, electrolyte abnormalities from profuse diarrhea, and anemia from rectal bleeding.
• A surgical emergency exists if the colon becomes weakened at a site of inflammation and perforates, spilling bowel contents into the abdominal cavity.
• Other organs of the body may become inflamed, including the eyes, muscles, joints, skin, and the liver.
• Primary sclerosing cholangitis may be associated with severe ulcerative colitis. In this condition the ducts that drain bile from the liver become inflamed and scared.

Colon cancer is the major long-term complication of ulcerative colitis. The risk of colon cancer begins after ulcerative colitis has been present for 8 to 10 years and increases by 1% to 2% for every year that the disease is present. The risk is greater for those whose entire colon is affected as opposed to those who have only a small segment involved such as the rectum. Screening colonoscopy is recommended 8 to 10 years after the onset of the initial symptoms to look for cancer or pre-cancerous changes in the lining of the colon. Colonoscopy should be repeated routinely, the frequency depends upon whether a part or all of the colon is involved with the disease and how long the disease has been present.

• Primary sclerosing cholangitis may be associated with severe ulcerative colitis. In this condition the ducts that drain bile from the liver become inflamed and scared.
• Iritis or uveitis. These diseases indicate inflammation of the eye.
• Ankylosing spondylitis, a disease that causes inflammation in the joints between the vertebrae in the spine and the joints between the spine and the pelvis.
• Erythema nodusum, in which the skin becomes inflamed.

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