What is the perspective – will ulcerative colitis be curable?
Ulcerative colitis, as a chronic inflammatory bowel disease that strictly only affects the colon and rectum, is already curable in principle. Surgical removal of these intestinal sections prevents a recurrence of the disease. However, the operation is a major one and the consequences behind it should not be neglected: a non-substantial part of the intestinal system is removed, which has an effect on digestion and stool production; the stool is then removed either via an artificial intestinal outlet (stoma) or – if this is individually surgically possible – via a continent-preserving, surgically repositioned reservoir (ileoanal pouch).
There is currently no known drug therapy that can bring about a definitive cure for ulcerative colitis. This is particularly difficult because the cause of this disease is still not fully understood. The drug approach that is currently being successfully pursued to combat the symptoms suggests that it is a malfunction of the immune system.
What is the current life expectancy in ulcerative colitis?
Life expectancy in patients with existing ulcerative colitis depends primarily on the extent to which the colon and rectum are affected, but also on the complications that this chronic inflammatory bowel disease can present. Patients with an isolated infestation of the rectum and sigmoid colon usually have a completely normal life expectancy. The further the inflammation has spread through the colon, the greater the probability of complications.
If the entire colon and rectum (pancolitis) is affected, one speaks of a 20-year survival rate of about 80%. The course of the disease is also decisive: chronic-intermittent courses under adequate therapy usually have a better prognosis than chronic-continuous ones, as there is a permanent disease activity. The acute fulminant course can be life-threatening, when the disease suddenly appears in its fullest and most severe form. Complications that can become dangerous in the course of the disease are, for example, bleeding (acute mass bleeding or chronic bleeding), intestinal wall ruptures, an inflammatory co-reaction of the surrounding peritoneum (peritonitis), the so-called toxic megacolon (acute dilatation of the colon) and the development of a colon carcinoma at the base of the chronic inflammation of the intestinal wall.
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