Conditions You May Have Along With Ulcerative Colitis

As if ulcerative colitis (UC) wasn’t challenging enough to manage, the disease can also make you more likely to get other health conditions. Your risk could go up for ailments that range from depression to thinning bones to colon cancer.

That doesn’t mean you’ll get any of these problems. But it’s a good idea to be aware of them so you and your doctor can spot potential trouble early. Here are some UC-related conditions to know.

Depression

Living with an inflammatory bowel disease (IBD) like ulcerative colitis or Crohn’s disease can affect more than your body. Painful symptoms, disruptions to daily life, and unfair stigmas can take a toll on mental health, too. Rates of depression are higher for people with IBD than they are for people who don’t have it. Anxiety is common, too.

Talk to you doctor if you feel depressed or anxious. Treatments like talk therapy or medication could help. So could joining an online support group, where you can meet other people with UC who understand what you’re going through. And if you’re not doing light aerobic exercise already, ask your doctor how to get started because it too can lift your mood.

Skin, Joint, or Eye Problems

When you have UC, the lining of your large intestine gets inflamed and sets off your symptoms. For some people, this inflammation also shows up in other body parts during a flare. Experts aren’t sure why.

You could have symptoms like:

Let your doctor know whenever you get new UC symptoms. That way, they can change your treatment plan if needed.

Rectal Bleeding

The inflammation of UC causes sores called ulcers to form on the lining of your large intestine. These sores can open and bleed. The blood could leave your body through the bottom part of your colon (the rectum) and out the opening at the end, the anus. You might see blood in the toilet after you go to the bathroom or notice it on toilet paper after you wipe.

Continued

Some people with UC who have bloody diarrhea several times a day get a condition called anemia as a result. That means you’ve become low on red blood cells, and it can make you feel tired or weak. Your doctor can treat it by recommending an iron supplement and diet changes for you. If you have severe anemia, you may need a red blood cell transfusion.

It’s rare to have severe rectal bleeding. But if you have a lot of bleeding within a short amount of time, call your doctor or 911 right away. You might need surgery to stop it.

Dehydration and Malabsorption

When your large intestine is healthy, one key role it plays is to absorb water and some nutrients from food you’ve partially digested. Inflammation and diarrhea from UC can keep it from doing this and leave you dangerously dehydrated or low on certain nutrients. If this happens, you may need to go to the hospital to get fluids through a vein (IV).

Osteoporosis

This disease makes your bones thinner, weaker, and more likely to break. A milder form of it is called osteopenia. Over time you could get either condition due to ulcerative colitis itself or from corticosteroid treatments for it. If this happens, your doctor can recommend medications, as well as calcium or vitamin D supplements to keep your bone loss from getting worse or to slow it down.

Growth and Development Problems for Children

You can get ulcerative colitis at any age, but it’s more common among 15- to 30-year-olds. A child with UC may:

  • Be underweight
  • Grow more slowly or be short
  • Go into puberty later than usual

The disease and certain meds for it can affect a child’s height and weight. The doctor should track their growth often. Getting the inflammation of UC under control with the right treatment plan can help a child grow.

Deep Vein Thrombosis (DVT)

This is a blood clot in a deep vein. It usually shows up in your lower leg, thigh, or pelvis. It doesn’t always cause symptoms. But when it does, you might notice that your affected body part is:

  • Swollen
  • Tender to the touch or painful
  • Warm, crampy, or achy
  • Red or discolored

Continued

Talk to your doctor right away if you’re worried that you might have DVT. It’s possible for a deep-vein blood clot to break loose and get stuck in a lung artery. If that happens, it’s an emergency called a pulmonary embolism (PE). You could have symptoms like shortness of breath, sharp chest pain, and a cough with or without blood. Call 911 if you have these signs.

Doctors can treat DVT and pulmonary embolisms with medications, a filter through a vein that removes the clot, or (rarely) surgery.

You could be more likely to get DVT or PE if you:

  • Have ulcerative colitis that flares often or affects a large amount of your colon.
  • Get surgery for severe ulcerative colitis. (In general, major operations can raise anyone’s DVT risk.)

Some studies also link certain ulcerative colitis meds, like steroids or tofacitinib, to DVT and PE.

Colorectal Cancer

It’s rare to get this. In general, your risk for it starts to climb 8 years after you have your first ulcerative colitis symptoms. Your chances of getting it also go up if UC affects a lot of your large intestine. You may be able to lower your risk for colon cancer by following your UC treatment plan exactly because it controls inflammation.

It’s important to get a screening test for colon cancer, called a colonoscopy, as often as your doctor recommends. Usually that’s every 1 to 3 years, starting 8 years after you were diagnosed with UC. The test can spot unusual changes in your colon that could turn into cancer. It can also detect the disease early, when it’s easier to treat. The main treatments for colon cancer are surgery and chemotherapy. It’s rare, but some people need radiation therapy.

Colon cancer and UC have several symptoms in common, like stomach pain, diarrhea, and bloody stool (poop). That means only your doctor can tell the two conditions apart, so don’t try to do it on your own. Get checked.

Continued

Fulminant Ulcerative Colitis

This is an extremely severe type of UC that can bring on symptoms like bloody diarrhea more than 10 times a day. You may also have:

Less than 10% of people with UC get this complication. If you do, you’ll need hospital care. Treatments can include IV fluids, antibiotics, and other meds. If these don’t help, you may need surgery to remove part or all of your colon.

Perforation (Rupture) of the Bowel

This is a hole in your large intestine. It can form if ongoing inflammation and ulcers from UC weakening the wall of your intestine too much. Your chances for this go up if you have fulminant colitis.

A perforated bowel can give you symptoms like:

Call your doctor right away. If you have a ruptured intestine, it can be deadly. Bacteria inside it can spill into your belly and bring on a severe infection called peritonitis. Most people need surgery and antibiotics to get well.

Toxic Megacolon

This means your large intestine swells up and stops working. It’s rare, but it can be life-threatening. It can happen if inflammation from UC spreads into your large intestine’s deep layers. You’re more likely to get it if you have fulminant colitis.

Some symptoms of toxic megacolon are:

  • Belly swelling or pain
  • Fever
  • Fast heart rate
  • Shock
  • Diarrhea

Call your doctor or 911. If you have toxic megacolon, you need treatment right away. The doctor may give you medicines, IV fluids, and treatments that remove gas and other substances from your colon. If these don’t help enough, you may need surgery.

WebMD Medical Reference Reviewed by Neha Pathak, MD on February 09, 2021

Sources

SOURCES:

Clinical and Translational Gastroenterology: “Risk of thrombosis and mortality in inflammatory bowel disease.”

World Journal of Gastroenterology: “Venous thromboembolism in inflammatory bowel disease.”

Gastroenterology: “AGA Clinical Practice Guidelines on the Management of Moderate to Severe Ulcerative Colitis.”

Cedars Sinai: “Genetic Risk for Fatal Blood Clots Identified in IBD Patients.”

American Lung Association: “Treating and Managing Pulmonary Embolism.”

American Gastroenterological Association: “Ulcerative Colitis.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Definition & Facts of Ulcerative Colitis.”

American College of Gastroenterology: “Ulcerative Colitis.”

Crohn’s and Colitis Foundation: “Fact Sheet: Intestinal Complications,” “Navigating Daily Life with IBD,” “Depression and Anxiety,” “Crohn’s Disease and Ulcerative Colitis: A Guide for Parents.”

Up to Date: “Patient education: Ulcerative colitis (Beyond the Basics),” “Management of the hospitalized adult patient with severe ulcerative colitis,” “Patient education: Deep vein thrombosis (DVT) (Beyond the Basics),” “Patient education: Ulcerative colitis in children (The Basics).”

Johns Hopkins: “Toxic Megacolon.”

Sepsis Alliance: “Perforated Bowel.”

Cleveland Clinic: “Rectal Bleeding.”

National Cancer Institute: “Large Intestine.”

CDC: “What is Venous Thromboembolism?”

Medline Plus: “Osteoporosis,” “Bone Density.”

National Heart, Lung, and Blood Institute: “Venous Thromboembolism.”

Clinical and Translational Gastroenterology: “Risk of thrombosis and mortality in inflammatory bowel disease.”

© 2021 WebMD, LLC. All rights reserved.

Pagination