For people with UC, there are two factors affecting the risk of developing colon cancer. The first factor is that risk increases after 8 to 10 years of active UC. The second is the extent of the disease in the colon. People with disease only in the rectum have the lowest risk; disease in part of the colon involved carries an intermediate risk; disease in the entire colon has the greatest risk. Patients whose disease has been quiet have the same risk as those who have more active disease. However, more than 90% of IBD patients never develop colon cancer.
Colonoscopies will need to be repeated at regular intervals as determined by the gastroenterologist. After 8 to 10 years of UC, the doctor may recommend a colonoscopy every year or every two years. A gastroenterologist can make an individualized assessment of colon cancer risk based on history, other risk factors, and the extent and duration of UC.
Are there any other conditions connected with UC?An uncommon disease of the liver, primary sclerosing cholangitis (PSC), appears to be associated with UC. PSC causes narrowing inside and outside of the bile ducts in the liver. Symptoms include: diarrhea (from malabsorption of fat), fatigue, fever/chills (from an infection in the bile ducts), itching which often affects the entire body, and jaundice (yellowing of the skin and eyes). Most often, the people who are affected by PSC are men between the ages of 30 and 60, with the average age of diagnosis being 40.
Toxic megacolon is a serious complication of UC in which gases collect in the colon and cause it to inflate. This condition is fairly rare; it only occurs in about 2% of patients with UC. Symptoms include a distended abdomen, high fever, dehydration, rapid heart rate, abdominal pain and tenderness and sometimes loss of bowel sounds. Left untreated, the colon may rupture, a condition that is fatal in 30% of cases. A tube may be inserted into the colon to decompress it. If this treatment is unsuccessful, a may be necessary.
Is UC genetic?In recent years there has been a focus on the concept that IBD and may be even be linked to particular genes. Researchers have no clear answers about how IBD is passed between generations, but there is some research on the probability of children inheriting their parent's disease. There seems to be a stronger risk of inheriting Crohn's disease than UC, especially in Jewish families. However, children who have one parent with Crohn's disease have only a 7-9% lifetime risk of developing the condition, and just a 10% risk of developing some form of IBD. If both parents have IBD this risk is increased to about 35%.
What is the long-term prognosis for people with UC?The long-term prognosis is good, and improving as more research on treatments is conducted. The vast majority of people with UC can manage their disease medically, and will not need surgery or develop colorectal cancer or other life-threatening complications.
