If you have ulcerative colitis (UC), you probably know that inflammation causes many of your symptoms. But what is less commonly known is that it is also a likely culprit in an increased risk of colorectal cancer.
Why ulcerative colitis is linked to an increased risk of colorectal cancer
“The greater the inflammatory load, and perhaps the longer a person with UC has ongoing inflammation, the greater the risk of developing colorectal cancer,” he says. Edward L. Barnes, MDgastroenterologist and assistant professor of medicine at the University of North Carolina at Chapel Hill.
What’s more, if you are among the subset of people with UC who also develop primary sclerosing cholangitis (a rare condition that causes scarring of the bile ducts of the liver), your risk of colorectal cancer may be significantly higher.
What to do to prevent and detect colorectal cancer
You can take steps to reduce your risk of colorectal cancer.
1. Find a UC treatment that works
Newer medications for UC are allowing some people to achieve remission, Dr. Barnes says. If your current treatment regimen isn’t controlling your symptoms, talk to your doctor about exploring new options, he advises, both for “better symptom control and better quality of life.”
If your UC does not respond to medications, surgery is also an option. A procedure called proctocolectomy involves removing the entire colon and rectum to eliminate UC.
2. Once you find an effective treatment for UC, stick with it
“The main way we try to reduce the risk of colorectal cancer in patients with UC is better control of inflammation,” he says. “We hope that better control of UC will reduce your risk of developing colorectal cancer.”
3. Eat a nutritious diet and avoid trigger foods
You should also stay away from any foods that seem to trigger your symptoms. Triggers usually vary from person to person, but in general, it is helpful to avoid foods high in fat or refined and added sugars, as well as:
- Dairy products with high lactose content
- Caffeine
- Alcohol
- Raw fruits and vegetables, which are harder on the intestine than cooked, chopped or pureed fruits and vegetables.
- spicy foods
4. Exercise regularly
Exercise can help manage many of the complications of UC, including reduced bone density, the mental health effects of living with UC, and a weakened immune system, which can hinder the body’s ability to ward off inflammation.
5. Get screened for cancer
Colorectal cancer may develop earlier in people with inflammatory bowel disease (IBD) than in people without it, says Amosy Ephrem M’Koma, MDcolon and rectal surgeon at Vanderbilt-Ingram Cancer Center in Nashville.
Basically, this is because the cumulative inflammation in the colon seen in UC likely accelerates the development of cancer-causing genetic mutations, says Dr. Ephreim M’Koma.
This is called a “surveillance colonoscopy,” and your doctor will “look for any early signs of dysplasia or precancerous changes,” Barnes says. “The presence of dysplasia often triggers changes in the way we manage the patient’s condition. Ensuring that the patient undergoes colonoscopies to try to identify these changes early, before they develop colorectal cancer, is a key point in controlling risk.”
The takeaway
- The inflammation caused by ulcerative colitis can cause cellular changes in the rectum and colon that increase the risk of colorectal cancer.
- Managing UC with medications, getting cancer screenings every one to three years after diagnosis, avoiding trigger foods, eating a balanced diet, and exercising regularly can contribute to reduced inflammation and a lower risk of colorectal cancer.
- Work closely with your doctor to control your UC and your cancer risk as much as possible.
