UC symptoms improve during periods of remission and
worsen during periods of relapse or flare-ups. More frequent
or severe flare-ups may indicate that your UC is progressing
or your treatment is not working.
The primary goal of treatment is to bring the condition into remission and keep it there.
Ulcerative Colitis Progression Guide
Increased
flare-ups
Systemic
inflammation
Extraintestinal manifestations
Treatment
changes needed
Surgery
As it progresses, UC may cause more systemic inflammation throughout your body. This can lead to new or worsening gastrointestinal symptoms and symptoms in other parts of your body. It may cause higher erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, markers of inflammation a doctor measures with blood tests.
Your doctor can also measure inflammation using a stool test called fecal calprotectin.
These symptoms can worsen when UC is more active. People with UC may also have a higher risk of some types of kidney disease, liver disease, anemia, and osteoporosis.
Increased
flare-ups
Systemic
inflammation
Extraintestinal manifestations
Treatment
changes needed
surgery
Colorectal
cancer risk
Colorectal
cancer risk
About 10–30% of people with UC develop extraintestinal manifestations, which are signs of inflammation outside the intestines. For example, you may develop:
eye redness and discomfort
joint pain and swelling
a skin rash or sores
Sometimes, surgery is needed to treat moderate to severe UC.
biologics
small molecule therapies — Janus kinase (JAK) inhibitors and sphingosine-1 phosphate (S1P) receptor modulators
immunosuppressants
Your doctor may prescribe aminosalicylates or corticosteroids to treat mild to moderate UC. If the condition progresses or doesn't respond well to these treatments, your doctor may recommend a change in treatment. Medications for moderate to severe UC include:
have widespread or severe inflammation
have developed UC and are under 40 years old
About 10–15% of people with UC need a colectomy within
5–10 years of developing the condition. A colectomy is surgery to remove part or all of the colon. You're more likely to need a colectomy if you:
have signs or symptoms of inflammation outside
the intestines
The American College of Gastroenterology recommends a colonoscopy every 1–3 years if you have UC that extends beyond the rectum to screen for colorectal cancer, starting
8 years after diagnosis.
how long you've had UC
how severe UC is
your age at diagnosis
People with UC are 2–3 times more likely than average to develop colorectal cancer. The risk may depend on factors such as:
related conditions you
may have