You may notice relief in UC symptoms during periods of remission and worsening 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 as expected.
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 UC progresses, it may cause more systemic inflammation throughout your body. This may lead to new or worsening gastrointestinal symptoms.
You may also experience more generalized symptoms like
fatigue, unintended weight loss, and abdominal pain, or develop complications like anemia.
UC 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
Approximately 1 in 3 people with UC develop extraintestinal
manifestations, or symptoms. These are signs of inflammation outside the intestines. For example, you may develop:
mouth sores
eye redness and discomfort
a skin rash
Sometimes, surgery is needed to treat moderate to severe UC.
biologics
small molecule therapies, including 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 the age of 40 years
About 10% to 15% of people with UC need a colectomy within
5 to 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 to 3 years, starting 8 years after diagnosis,
to screen for colorectal cancer if you have UC that extends
beyond the rectum.
how long you've had UC
how severe UC is
your age at diagnosis
People with UC are 2 to 3 times more likely to develop colorectal cancer than people without UC. The risk may depend on several factors, such as:
related conditions you
may have
joint pain and swelling