Prognosis

Look for ^c  

• abdominal distension 
• localised or generalised peritonitis 
• fever ≥38°C 
• tachycardia > 120 beats/minute 
• leucocytosis > 11x 10⁹/l 
• small bowel distension on plain abdominal X-ray ^c   

Colectomy is common in acute colitis ^b  

Patients are at increased risk with

• ≥ 6 bowel motions on the day of admission  ^b  
• > 8 bowel actions and a CRP > 45 on the third day of admission  ^b  
• fever ≥ 38 °C or pulse ≥ 90 on any day  ^b  
• serum albumin level ≤ 35 g/l  ^b  
• pancolitis or small bowel distention on abdominal X-ray  ^c  
• severe endoscopic colitis ^c  
  • extensive deep ulcerations or well-like ulcerations
  • mucosal detachment on the edge of these ulcerations
  • large mucosal abrasions

   

Relapse and subsequent surgery are common following discharge ^b but death is uncommon. ^b  

Disease extension is common in ulcerative colitis. ^b  

The risk is increased with ^b  

• toxic, fulminant or severe colitis 
• joint symptoms 
• left-sided disease at diagnosis

Systemic manifestations are uncommon. ^b  

Colorectal cancer is uncommon  

The risk with ulcerative colitis is increased with  

• increasing duration of the disease ^b
• a first-degree relative with colorectal cancer ^b