Prognosis

The prognosis of ulcerative colitis:

• a colectomy is curative
• 70% of patients with untreated UC relapse annually
• there is a 1% risk of the development of colonic cancer if someone has the disease for 10 years; in most UK centres, patients with extensive UC of 10 years' duration are offered colonoscopy every 1-2 years in an effort to prevent colonic cancer by taking multiple biopsies to look for mucosal dysplasia and to offer colectomy if appropriate, or to detect cancer at a curable stage
• there is a substantial variation in severity, extent and responsiveness, together with extra-intestinal and multiple intestinal manifestations
• life-expectancy is similar to that of the general population
• patients with well-controlled distal UC can be followed up routinely in primary care (will require a blood count and liver function test every 6-12 months, and referral for colonoscopy at 8-10 years to reassess disease extent)

Reference

1. NICE. Ulcerative colitis: management. NICE guideline NG130. Published May 2019, reviewed February 2025