Ulcerative Colitis

Complications of Ulcerative Colitis

Complications are by no means an inevitable or even a frequent consequence of ulcerative colitis, especially in appropriately treated patients. But they are sufficiently common and cover such a wide range of manifestations that it is important for patients and physicians to be acquainted with them. Early recognition often means more effective treatment.

Local complications of ulcerative colitis include profuse bleeding from deep ulcerations, perforation (rupture) of the bowel, or simply failure of the patient to respond appropriately to the usual medical treatments.

Another complication is severe abdominal distension. A mild degree of distention is common in individuals without any intestinal disease and is somewhat more common in people with ulcerative colitis. However, if the distention is severe or of sudden onset, and if it is associated with active colitis, fever, and constipation, your physician may suspect a serious complication of colitis, called toxic megacolon. Fortunately, this is a rare development. It is produced by severe inflammation of the entire thickness of the colon, with weakening and ballooning of its wall. The dilated colon is then at risk of rupturing. Treatment is aimed at controlling the inflammatory reaction and restoring losses of fluid, salts, and blood. If there is no rapid improvement, surgery may become necessary to avoid rupture of the bowel.