Can Inflammatory Bowel Disease Be Fatal?

Crohn's Disease And Ulcerative Colitis Are Associated With Many Complications

Doctors
Do you have a lot of people on your healthcare team? That's a good thing! People with IBD need to get health issues checked out right away, before they turn into bigger problems.. Photo © photostock

Inflammatory bowel disease (IBD) -- Crohn's disease and ulcerative colitis -- is a chronic, lifelong condition. In many cases, IBD and its complications can be managed with treatments that include medication and surgery. IBD is not generally thought of as a fatal condition. However, that doesn't mean that people with IBD never die from IBD-related causes, it just means that it is not common.

While this is a scary topic, it's important to remember that treatments for IBD are constantly improving.

Stopping inflammation and preventing flare-ups is the ultimate goal in IBD treatment, and can help prevent complications. Keeping up with regular doctor's appointments and taking care of health problems that crop up -- even if they seem unrelated to the IBD -- is also going to be an important part of staying as healthy as possible.

Does IBD Increase Your Risk Of Death?

People with IBD do have a greater risk of death than the general population (people that do not have IBD). This is perhaps not surprising, but it can be a bit confusing. There are a great many reasons someone with IBD might die: complications from surgery, a reaction to medication, developing a serious related condition (such as a liver disease or toxic megacolon). In some cases, it's unknown if a person's IBD actually contributed to their death or not.

What The Research Says

There have been several studies that have looked at the cause of death in people who have IBD.

One study of 692 patients in Minnesota found that the overall life expectancy of people with IBD was "similar" to those who do not have IBD. For those with Crohn's disease, cause of death from gastrointestinal disorders and chronic obstructive pulmonary disease (COPD) were more common than in the general public.

The authors indicate that stopping smoking is crucial for patients with Crohn's disease to avoid serious complications. For people with ulcerative colitis, there was actually a decrease in the deaths from cardiovascular disease. The authors explain that this could be from a low incidence of smoking in ulcerative colitis patients, and low levels of sodium and water in the body due to ileostomy or extensive colitis.

A second study in England showed that the most deaths occurred in the first year after diagnosis, but most of those deaths were not from IBD, but from some other cause. A very severe first flare-up or Crohn's disease in the colon or the perianal area were also correlated with increased mortality. The authors also point out that older patients who are recently diagnosed with IBD may be at increased risk of dying.

One large study from Manitoba was done to understand the cause of death in people with Crohn's disease and ulcerative colitis. What they found was that people with IBD had an increased risk of death particularly after having surgery and in the first year of diagnosis.

 

The Bottom Line

Overall, the IBDs are not generally fatal conditions, but they are serious diseases. While death from IBD is uncommon, it is still important to seek treatment and develop an overall healthy lifestyle. People with Crohn's disease and ulcerative colitis are particularly susceptible to complications, and the first year of diagnosis and the year after surgery are vulnerable times. While this is sobering information, the good news is that surgical techniques and treatments for IBD are constantly improving. People with IBD who are concerned about their life expectancy should talk with their gastroenterologist about how to reduce the risk of complications.

Sources:

Duricova D, Pedersen N, Elkjaer M, et al. "Overall and cause-specific mortality in Crohn’s disease: a meta-analysis of population-based studies." Inflamm Bowel Dis. 2010;16:347-353.

Farrokhyar F, Swarbrick ET, Grace RH, Hellier MD, Gent AE, Irvine EJ. "Low mortality in ulcerative colitis and Crohn's disease in three regional centers in England." Am J Gastroenterol. 2001 Feb 96:501-507. Jun 26 2008.

Hovde Ø1, Kempski-Monstad I, Småstuen MC, et al. "Mortality and causes of death in Crohn's disease: results from 20 years of follow-up in the IBSEN study." Gut. 2014 May;63(5):771-775. 15 Jan 2016.

James D. Lewis, Joel M. Gelfand, Andrea B. Troxel, Kimberly A. Forde, Craig Newcomb, Hopiy Kim, David J. Margolis, and Brian L. Strom. "Immunosuppressant Medications and Mortality in Inflammatory Bowel Disease." Am J Gastroenterol. 2008. 103:1–8. Jun 26 2008.

Jess T, Loftus EV Jr, Harmsen WS, Zinsmeister AR, Tremaine WJ, Melton LJ 3rd, Munkholm P, Sandborn WJ. "Survival and cause specific mortality in patients with inflammatory bowel disease: a long term outcome study in Olmsted County, Minnesota, 1940-2004." Gut. 2006. Sep 55:1248-1254. Jun 26 2008.

Jess T, Gamborg M, Munkholm P, Sørensen TIA. "Overall and cause-specific mortality in ulcerative colitis: meta-analysis of population-based inception cohort studies." Am J Gastroenterol. 2007;102:609-617.

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