Ulcerative colitis may result in disease-related mortality. However, overall mortality is not increased in patients with ulcerative colitis, compared with the general population.
An increase in mortality may be observed among elderly patients with the disease. Mortality is also increased in patients who develop complications (eg, shock, malnutrition, anemia). Evidence suggests that mortality is increased in patients with ulcerative colitis who undergo any form of medical or surgical intervention.
Involvement of the muscularis propria in the most severe cases can lead to damage to the nerve plexus, resulting in colonic dysmotility, dilation, and eventual infarction and gangrene—a condition termed "toxic megacolon." This condition is characterized by a thin-walled, large, dilated colon that may eventually become perforated. Chronic disease is associated with pseudopolyp formation in about 15%-20% of cases. Chronic and severe cases can be associated with areas of precancerous changes, such as carcinoma in situ or dysplasia.
The most common cause of death in patients with ulcerative colitis is toxic megacolon. Colonic adenocarcinoma develops in 3%-5% of patients with ulcerative colitis, and the risk increases as the duration of disease increases. The risk for colonic malignancy is higher in patients with pancolitis and those with onset of the disease before the age of 15 years. Benign stricture rarely causes intestinal obstruction.
For more on the prognosis of ulcerative colitis, read here.
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Cite this: Marc D. Basson. Fast Five Quiz: How Much Do You Know About Ulcerative Colitis? - Medscape - Oct 19, 2015.