Ulcerative colitis (UC) is a chronic inflammatory condition affecting the colon. In North America, its prevalence surpasses 400 per 100,000 individuals. Those with UC tend to have a reduced life expectancy and are at a heightened risk for colectomy and colorectal cancer. The disease can significantly impair quality of life due to symptoms like chronic diarrhea and rectal bleeding. Around 27% of UC patients experience extraintestinal manifestations, such as primary sclerosing cholangitis. Monitoring is essential, with colonoscopy recommended 8 years post-diagnosis for dysplasia surveillance.
Treatment strategies are guided by disease location and activity. Mild to moderate UC is primarily treated with 5-aminosalicylic acid. For moderate to severe cases, oral corticosteroids may be used initially, followed by biologic monoclonal antibodies or oral small molecules targeting specific inflammation pathways. However, the highest response rate to these treatments is between 30% to 60% in clinical trials. Within five years of diagnosis, about 20% of UC patients are hospitalized, and roughly 7% undergo colectomy. After 20 years of disease duration, the risk of colorectal cancer is 4.5%. Overall, life expectancy for UC patients is approximately 80.5 years for females and 76.7 years for males, which is around 5 years less than those without UC.
- How can the healthcare system better address the reduced life expectancy and increased risks associated with UC?
- Given the limited response rate to current treatments, what are the potential avenues for research and development in UC therapies?
- How can patient quality of life be improved, considering the chronic nature of UC and its debilitating symptoms?