LIFE EXPECTANCY IN ULCERATIVE COLITIS

introduction

Ulcerative colitis is a chronic inflammatory bowel disease. As the name suggests, the disease is chronic. That means that it accompanies most of those affected for a lifetime. In the case of chronic diseases, the question arises for many patients as to whether the disease has an impact on life expectancy or not. This question will be examined in more detail in the following sections.

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What influence does ulcerative colitis have on life expectancy?

From a medical point of view, patients with ulcerative colitis do not have to fear any significant reduction in life expectancy. From a statistical point of view, it looks a little different. This has to do with the fact that ulcerative colitis can be associated with certain complications that can be potentially life-threatening and thus have an impact on life expectancy.
Typical complications are:

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The so-called toxic megacolon. The intestine expands more and more in a certain section. It becomes so big that there is a risk of it perforating, i.e. bursting. One then speaks of an intestinal perforation. Such an intestinal perforation is an acutely life-threatening clinical picture. Immediate surgical treatment is necessary. About 4% of patients who suffer from a toxic megacolon that has not yet burst die from it. If intestinal perforation occurs, the mortality is even around 20%.
Intestinal bleeding is another potentially serious complication of ulcerative colitis. If there is significant bleeding, immediate surgical therapy may also be necessary. However, with prompt and adequate treatment, mortality is very low.
There is also an important long-term complication of ulcerative colitis: Patients suffering from colitis develop a significantly increased risk of colon cancer over the years. The risk increases significantly after 10 years of illness compared to the normal healthy population. Colon cancer is fatal if left untreated. Therefore, statistically speaking, the increased risk of colon cancer in ulcerative colitis can lead to a reduced life expectancy. In reality, however, all patients who have suffered from ulcerative colitis for many years are given close-knit colon cancer screening examinations (colonoscopies). The intestine is mirrored and examined for possible cancer precursors. If such a precursor or a cancerous growth is detected and removed early, the mortality is very low. In summary, it can be said that the life expectancy of a patient with ulcerative colitis who is under regular medical monitoring and treatment is hardly or not limited.

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Symptoms of ulcerative colitis
Toxic megacolon
Colon cancer

How do the relapses affect life expectancy?

Although ulcerative colitis is a chronic disease, it differs from patient to patient. There are patients who live without symptoms for years after a relapse. Other patients have very frequent relapses. The frequency of the attacks is an indicator of the activity of the disease. The more active the disease, the more aggressively it attacks the intestinal wall. With a disease with high disease activity, the risk of complications such as the toxic megacolon or acute bleeding is higher than with diseases that are associated with a low activity / relapse frequency. The risk of colon cancer is also related to how badly the intestinal wall was damaged by the disease. This means that patients with frequent strong flare-ups have a higher risk of complications than patients with rare flare-ups and low disease activity. Statistically speaking, life expectancy is slightly lower in the case of a disease with high disease activity / frequent relapses. From a medical point of view, the life expectancy of patients with a higher and lower frequency of relapses hardly differs with regular specialist presentations and care.

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Read more on this topic at: Relapses in ulcerative colitis and mesalazine

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What influence does the therapy have on life expectancy?

The therapy of ulcerative colitis significantly influences the disease activity. Without treatment, the colitis is in most cases much more aggressive than with treatment. Drug therapy can even achieve remission in a certain number of patients, so this is where the disease comes to rest. However, it can break out again at any time. Drug therapy therefore has a decisive influence on the risk of complications in ulcerative colitis. With adequate therapy, complications such as the toxic megacolon or intestinal bleeding occur significantly less often.
The risk of colon cancer also depends to a certain extent on the activity of the disease. Even with colitis that has been well-treated with medication, there is still a certain risk of complications, so that every patient with colitis, even those who have been very well controlled with medication, needs to be regularly seen and looked after by a specialist. Colon cancer screening examinations must also be carried out regularly for patients who have been optimally adjusted with medication from a certain duration of illness. In principle, drug therapy has a positive effect on life expectancy and, above all, the quality of life of patients.

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Therapy of ulcerative colitis
Can you cure ulcerative colitis?

What influence does the risk of degeneration have on life expectancy?

The risk of colon cancer (Colon cancer) is higher in patients with ulcerative colitis than in the normal population. The risk of colon cancer increases exponentially with the duration of the disease. The longer the disease lasts, the higher the risk of colon cancer developing.According to current studies, after a disease duration of 10 years, the risk is around 2%, after 20 years of disease around 8% and after 30 years of disease around 18%. This illustrates the large and important role of colorectal cancer screening (preventive colonoscopy) in patients with ulcerative colitis. In Germany, colorectal cancer screening is recommended to healthy patients aged 55 and over and is covered by health insurance companies.
In patients with ulcerative colitis, preventive medical examinations must be started much earlier and carried out more frequently. If a degeneration of the intestinal mucosa is detected early through a colonoscopy, the chances of treatment are very good and life expectancy is hardly affected. If the regular screening colonoscopies are not used, there is an above-average risk that the colon cancer will only be diagnosed at an advanced stage. Then the chances of treatment are worse. Colon cancer in advanced stages can have a significant impact on life expectancy.

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