The following complications might be behind your loved one’s UC emergency. These result from serious tissue damage in the colon and rectum.
Acute Severe Ulcerative Colitis
Sometimes called fulminant colitis, this complication affects less than 10 percent of people with ulcerative colitis and involves damage to the entire thickness of the intestinal wall. Unless urgent treatment can bring the inflammation under control, people with fulminant colitis risk developing toxic megacolon, the most severe colitis complication.
Recognizing acute severe ulcerative colitis early and closely monitoring a person’s condition while they receive intravenous corticosteroids are essential for treating fulminant colitis. They’ll also need to stay in the hospital and receive IV fluids until they are sufficiently rehydrated.
Toxic Megacolon
Considered the most serious complication of ulcerative colitis, toxic megacolon is the most extreme (and potentially life-threatening) form of fulminant colitis. It’s rare, occurring in around 5 percent of severe ulcerative colitis flares, but it’s important to look out for as a caregiver.
In toxic megacolon, a portion of the large intestine becomes paralyzed, stops working, and swells to many times its standard size. Without treatment, a portion of the intestine can become so severely damaged that it perforates.
Signs of toxic megacolon include:
- Worsening abdominal pain
- A visibly distended or bloated abdomen
- Abdominal tenderness
- Rapid heart rate
- High fever
- Dehydration
- Vomiting
- Frequent and bloody diarrhea
- Shock symptoms, including cool or clammy skin, confusion, breathlessness, and a weak pulse
To minimize the likelihood of toxic megacolon, avoid the following during a flare:
Perforated Bowel and Hemorrhaging
A perforated bowel is a hole in the wall of the intestine that can occur due to toxic megacolon, surgical injuries, or severe ulcerative colitis.
If the bowel is perforated, the gut’s contents can spill into the rest of the abdomen, leading to an infection called peritonitis. In turn, this can lead to a life-threatening infection response called sepsis.
A colonoscopy during periods of severe inflammation is more likely to result in perforation.
If you suspect perforation, call 911 or go to the emergency room. Massive hemorrhaging in a person with ulcerative colitis is an emergency that requires immediate medical attention and possibly surgery to repair the hole in the colon wall.
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