Untreated ulcerative colitis: Risks and can you die?

Ulcerative colitis is a type of inflammatory bowel disease. In people with ulcerative colitis, an overactive immune system attacks the lining of the colon, causing ulcers and inflammation. Symptoms typically include:

  • frequent diarrhea
  • abdominal pain
  • bloody stools
  • stomach cramps

These symptoms can range from mild to severe, and they tend to come and go in cycles.

When a person has few or no symptoms, doctors refer to it as being in remission. When symptoms suddenly get worse, they call it a flare-up.

In this article, we discuss the potential consequences of people leaving ulcerative colitis untreated, and whether a person can die from this condition.

We also cover when to see a doctor and treatment options.

Untreated ulcerative colitis

Ulcerative colitis tends to be a progressive condition that does not get better on its own.

Without treatment, symptoms may persist and get worse, and inflammation may spread within the colon. There is also a risk for further damage to the lining of the colon with every flare-up. This can make it harder for a person to manage the condition, going forward.

In children, not treating ulcerative colitis can limit growth and interfere with their overall development.

If people do not treat ulcerative colitis, it may lead to:

  • nutritional deficiencies
  • loss of appetite
  • swollen abdomen
  • fatigue
  • unintended weight loss
  • anemia
  • fever
  • rapid heartbeat
  • bleeding from the rectum
  • ruptured bowel
  • greater risk of colon cancer

Ulcerative colitis may also increase the risk of physical and mental health complications, such as:

  • arthritis
  • skin problems
  • eye inflammation
  • liver and kidney problems
  • bone loss
  • stress
  • depression

The only cure for ulcerative colitis involves the surgical removal of the colon. However, medications and diet can relieve symptoms, slow progression, and help a person stay in remission for longer.

The earlier a person begins treatment, the more effective that treatment is likely to be.

A 2014 review indicates that, after achieving remission, individuals who follow their treatment plans reduce their risk of flare-ups by around 40 percent. In contrast, those who stop taking their medication have a five-times greater risk of relapse.

For people with severe ulcerative colitis, prompt treatment can help prevent complications. Research suggests that long-term inflammation in the large intestine can lead to colonic dysplasia and even colorectal cancer.

According to the Crohn’s and Colitis Foundation, around 5–8 percent of people develop colorectal cancer within 20 years of a diagnosis of ulcerative colitis. This figure compares with 3–6 percent of people without the condition.

The risk of developing cancer increases in individuals with severe ulcerative colitis and in those who have had the disease for longer.

Doctors can prescribe a range of medications to treat people with ulcerative colitis. Treatment aims to relieve symptoms and induce and maintain remission.

Available treatment options for ulcerative colitis can include:

  • Antidiarrheal medications: These can help reduce or stop diarrhea but are usually for short-term use.
  • Aminosalicylates: This class of drugs can help control inflammation in people with mild to moderate symptoms.
  • Corticosteroids: Doctors often prescribe these for short-term relief of more severe symptoms and to induce remission
  • Immunomodulators: These drugs suppress the immune system to help reduce inflammation in the colon. An immunomodulator might be necessary if treatment with an aminosalicylate was unsuccessful.
  • Biologics: These are antibodies that target specific parts of the immune system. Healthcare professionals typically reserve biologics for people with symptoms that do not respond to other treatments.
  • Dietary supplements: Supplements can help address anemia and other nutritional deficiencies.
  • Antibiotics: Infected abscesses and ulcers may require a course of antibiotics if untreated ulcerative colitis has caused them to occur.
  • Surgery: A healthcare professional may recommend surgery for people with severe or difficult-to-treat ulcerative colitis. This can involve removing part or all of a person’s colon.

Lifestyle changes may also help a person better manage their ulcerative colitis. For instance, research suggests that a low-fat diet with plenty of vegetables may reduce the risk of developing ulcerative colitis.

Lifestyle modifications that may help a person manage their symptoms include:

  • drinking more liquids but avoiding sodas and other fizzy drinks
  • replacing large meals with smaller, more frequent ones
  • using a journal to track foods that may trigger flare-ups
  • limiting high-fiber and high-fat foods, during flare-ups


Ulcerative colitis is a long-term disease that can vary in its symptoms and severity. Medications and diet can help relieve symptoms, maintain remission, and slow progression. The only cure for ulcerative colitis involves the surgical removal of the entire colon.

If left untreated, symptoms of ulcerative colitis can get worse and may become more challenging to treat in future. Successful treatment also reduces a person’s risk of developing severe and potentially life-threatening complications.

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