Introduction
Ulcerative colitis is one of the chronic inflammatory bowel diseases. As the name suggests, the disease has a chronic course. This means that it accompanies most sufferers throughout their lives. In the case of chronic diseases, many patients are therefore faced with the question of whether the disease has an influence on life expectancy or not. This question will be examined in more detail in the following sections.
What influence does ulcerative colitis have on life expectancy?
From a medical point of view, patients with ulcerative colitis do not have to fear a significant reduction in life expectancy. From a statistical point of view, the situation is slightly different. This has to do with the fact that ulcerative colitis can be accompanied by certain complications that can be potentially life-threatening and thus have an impact on life expectancy.
Typical complications are:
- …the so-called toxic megacolon… In this case, the intestine expands more and more in a certain section. It becomes so large that there is a risk of it perforating, i.e. bursting.
This is called an intestinal perforation. A perforation of this kind is an acutely life-threatening clinical picture. Immediate surgical treatment is necessary.
About 4% of patients suffering from a toxic megacolon that has not yet burst die from it. If an intestinal perforation occurs, the mortality rate is even about 20%. – Another potentially serious complication of ulcerative colitis is intestinal bleeding.
In cases of severe bleeding, immediate surgical treatment may also be necessary. However, mortality is very low with rapid and adequate treatment. – There is also an important long-term complication of ulcerative colitis: patients suffering from colitis develop a significantly increased risk of colon cancer over the years.
The risk increases significantly after 10 years of illness compared to the healthy normal population. Untreated, intestinal cancer is fatal. Statistically speaking, the increased risk of colon cancer in ulcerative colitis can therefore lead to a reduced life expectancy.
In reality, however, all patients who have been suffering from ulcerative colitis for many years are subjected to comprehensive colorectal cancer screening (colonoscopy). In these examinations, the intestine is mirrored and examined for possible precancerous stages. If such a preliminary stage or cancerous growth is detected and removed early, the mortality rate is very low. In summary, it can be said that the life expectancy of a patient with ulcerative colitis who is under regular medical monitoring and treatment is hardly or not at all limited.
What influence do the relapses have on life expectancy?
Although ulcerative colitis is a chronic disease, its course varies from patient to patient. There are patients who live for years without symptoms after a relapse. Other patients have very frequent relapses.
The frequency of relapses is an indicator of the activity of the disease. The more active the disease is, the more aggressively it attacks the intestinal wall. In a disease with high disease activity, the risk of complications such as toxic megacolon or acute bleeding is therefore higher than in diseases with low activity/reflux frequency.
The risk of colorectal cancer is also related to the extent to which the intestinal wall has been damaged by the disease. This means that patients with frequent, strong relapses have a higher risk of complications than patients with rare relapses and low disease activity. Statistically speaking, life expectancy is therefore slightly lower in patients with high disease activity/frequent relapses. From a medical point of view, with regular specialist presentation and care, life expectancy hardly differs between patients with higher and lower relapse frequency.
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