For Your Patients: Possible Long-Term Complications of Ulcerative Colitis

"Medical Journeys" is a set of clinical resources reviewed by physicians, meant for the medical team as well as the patients they serve. Each episode of this 12-part journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.

As time goes on, you will probably maintain good control of your ulcerative colitis symptoms. But that doesn't mean the underlying disease has gone away. While the inflammation may be kept to a low level, it is typically kept low only with continued medications. For many patients, the inflammation is still there and can affect other parts of your body as well.

Some of the long-term risks that patients can face include:

• Increased likelihood of colorectal cancer

• Heart disease and other cardiovascular conditions

• Osteoporosis

• Vitamin/mineral deficiencies

• Drug side effects

Fortunately, there are steps you can take to reduce these risks:

• For colorectal cancer, your doctor may recommend that you undergo colonoscopy screening if you have had significant inflammation in your colon. Colonoscopy frequency may vary depending on how much inflammation you have had and how controlled the inflammation has been, with a range from every year to every 5 years, so that any bowel tumors can be caught early.

• Pay attention to any risk factors you may have for cardiovascular disease. Make sure you get plenty of exercise, watch your weight and cholesterol intake, and stop smoking if you haven't already

• Osteoporosis can result from underlying inflammation but is also a side effect of chronic steroid treatment. If you've been on a steroid for more than a month or two, ask your doctor about alternative therapies. Smoking cessation and exercise also help to prevent osteoporosis

• Perhaps most easily prevented are nutrient deficiencies, which can result from dietary modifications or the colitis itself. Your doctor can test you for specific deficiencies and recommend certain foods and/or supplements to compensate

• Steroids are not the only medications with unwanted side effects. Many crop up primarily in the first weeks of therapy and then lessen, but some continue over time. In particular, patients using so-called targeted therapies (as covered in an earlier installment in this series) are more prone to infections. This makes it extra important to stay current on vaccinations and to be mindful of unnecessary exposures

Read previous installments in this series:

What Is Ulcerative Colitis?

I've Had Diarrhea That Won't Go Away -- What Should I Do?

UC -- Why Me?

Starting Drug Therapy for Ulcerative Colitis

Diet and Lifestyle Considerations

My Ulcerative Colitis Treatment Isn't Working. Now What?

Living With Ulcerative Colitis

Would Surgery Help My Ulcerative Colitis?