[Intestinal complications in ulcerative colitis]

Although cases of severe intestinal complications such as massive hemorrhaging, perforation, stricture and obstruction occur in some instances of ulcerative colitis, these are relatively infrequent in comparison to Crohn's disease. Many cases with such severe intestinal complications require surgery, sometimes acute surgical emergency, instead of medication as these can be less effective in terms of improvement of the disease. Cytomegalovirus infections, which are at times associated with intractable ulcerative colitis, has recently been considered an etiologic factor in the exacerbation and intractability of ulcerative colitis. Furthermore, colitic cancer, an important complication of ulcerative colitis, may occur at high incidence in patients experiencing long term courses of chronically active or frequently relapsing ulcerative colitis, and thus must be considered and managed appropriately. For the prevention of complications of ulcerative colitis, rapid induction of remission and long-term remission maintenance is essential, in addition to the emphasis in avoiding chronic administration of large doses of steroids.