Ulcerative Colitis, Complications, and Cancer

QUESTION: Our adult son has just been diagnosed with ulcerative colitis and
we are very concerned. Would you please tell us if there can be serious
complications with the disease, and can it cause cancer? We want to find out
all we can so that we can help him.
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ANSWER: This is a chronic disease, which frequently is first noticed in the
period between 15 and 30 years of age. It usually starts as a series of
attacks of crampy abdominal pain, frequent urge to move the bowels, and
diarrhea containing mucus and blood, which can be exceedingly acute. Thus
hemorrhage is the most frequent local complication. Frequent complications
which may occur outside of the colon include arthritis, an inflammation of the
eye called iritis or episcleritis, as well as skin sores and ulcers. At times
a fever may develop, usually when there is a flare up of other colitis
symptoms. All patients do not get all these complications, nor need they be
severe. Cancer of the colon need not be a consequence of colitis, but the
risk seems confined to patients with long-standing, extensive ulcerative
colitis of more than ten years' duration. It is for this reason that regular
colonoscopic examinations are recommended for these patients, best taking
place during quiet periods when the disease is not active. When the course of
the disease is mild, life expectancy is normal. When cancer does occur, the
outcome of treatment is about the same as for any other colon cancer patient.
There are many effective treatments available that can help moderate the
discomfort and pain of colitis, as well as improve the prognosis