It is important to get treatment for ulcerative colitis as soon as possible. You should not delay treatment or downplay your symptoms to your doctor. This could make a mild case worse.
“The longer ulcerative bowel disease (IBD) smolders the more difficult it is to rein in,” Nirupama Bonthala MD, a doctor and researcher at Cedars Sinai in Los Angeles, says. “We see patients who are not treated properly, then their illness progresses to a more serious or manageable stage. This is a huge problem that we see time and again.”
Dr. Bonthala, for example, suggests that people with ulcerative colitis early in life may be able use less-effective (but still effective) medications with fewer side effects such as aminosalicylates.
These medications might not be effective for those whose disease has been untreated for a longer time, as there may be more inflammation. Bonthala says that as the disease progresses, you may need to take stronger medications than you initially needed. Even if we do try strong medicines, it’s not guaranteed that they will work. This can lead to surgical intervention.
These are the long-term consequences of untreated or undertreated ulcerative colitis.
1. Chronic fatigue could be a possibility.
Bonthala states that active inflammation is like a marathon. “You waste a lot of time.” Research supports this assertion: In a March 2020 Journal of Crohn’s and Colitis, a study found that people in remission experienced less fatigue than those with Crohn’s disease or active ulcerative colitis.
2. Your immune system may suffer.
Inflammation can cause constant stress to your body which can make you more susceptible to infection and other diseases. Bonthala says that your body is working so hard to control inflammation that it doesn’t allow it to do the housekeeping tasks it’s supposed. People are less likely to catch other infections and have a harder time fighting illness.
3. Your risk of developing colorectal cancer may be higher.
The Crohn’s and Colitis Foundation explains that when there is inflammation in the colon, cells in the lining are constantly turning over to repair the damage. The chances of a mutation that could lead to cancer can rise with this constant turnover.
Unchecked inflammation in the colon can make it difficult to detect them during a colonoscopy. Bonthala states, “You want to be able to start with a clean slate for a colonoscopy so that your doctor can make sure everything is in order.”
4. Your risk of developing osteoporosis may be higher.
Bonthala explains that osteoporosis can be caused by untreated or undertreated ulcerative colitis. Active inflammation “steals” bone health. She explains that patients are still in the bone-building stage of their lives until their mid-30s. Active inflammation means that your bones are not receiving the nutrients they need.
Second, flares from ulcerative colitis that are not properly managed can often be treated with steroids. This can cause osteoporosis. She says she receives a lot of referrals from patients with ulcerative colitis in their 20s to perform bone density tests.
5. There may be an increased chance of miscarriage or other complications during pregnancy.
Bonthala noticed that many patients with ulcerative colitis who are pregnant or trying for conceive are hesitant about taking medication. They are concerned about the effects on their baby.
She says, “It is important to make it clear that most medications are safe for pregnant and breastfeeding — with a few exceptions.” A bigger risk to pregnancy? IBD that is not treated.
A September 2020 review in the journal Digestion revealed that active IBD was associated with an increased chance of miscarriage and stillbirth, preterm birth, low birth weight, and other complications during pregnancy. Researchers found that inactive disease women before conception have similar pregnancy outcomes to those without IBD.
Bonthala suggests that you get your ulcerative colitis under control before trying to get pregnant. If you are already pregnant and have a flare, get treatment immediately.
6. It is possible to develop toxic megacolon.
Untreated ulcerative colitis can lead to inflammation in the colon, which can cause a dangerous condition called toxic megacolon. This condition can cause serious complications such as kidney failure or ruptured colon.
Bonthala states, “At this stage, there really is no other option for medical care than surgery.” To remove a toxic megacolon, you will need to have your entire colon removed.
How can you tell if you aren’t receiving the right treatment?
Patients with ulcerative colitis or any other chronic condition should keep track of their treatment and monitor their symptoms. Bonthala suggests that you keep a close eye on your bowel movements. This includes the frequency and how loose they are, as well as whether there is blood or mucus. If you experience sudden constipation, this could indicate that you should change your treatment.
You may also be suffering from intolerances to foods that you were used to eating.
Bonthala suggests that your doctor monitors your levels of inflammation by checking for high blood levels of C-reactive proteins. A stool test can be done by your doctor to determine if your stool contains fecal C-reactive protein, which is a substance your body makes when your intestines become inflamed.
What can you do if you believe that your child is being undertreated?
Bonthala suggests that you develop your health literacy. Dealing with chronic illness can seem overwhelming and intimidating. She says that there are many medical terms and medications. It’s overwhelming. To learn more about your condition and to find the right resources and professionals in your area to assist you, she recommends that you use the Crohn’s and Colitis Foundation.
Bonthala advises that you advocate for yourself if you feel you are not getting the best treatment for ulcerative colitis. Your doctor can tailor your treatment based on your condition. Don’t hesitate to ask for help if your current treatment isn’t working.
Bonthala, for her part is positive about the treatment of ulcerative colitis. She says, “I always tell my patients we all have the same goal: To achieve full remission.” “I want you to live like everyone else, not as if this disease is affecting you.
