Can Ulcerative Colitis Be Deadly?
Key takeaways
While ulcerative colitis itself is not fatal, it's a chronic disease that needs to be properly managed to prevent serious health complications.
Potentially serious health complications that can result from UC include toxic megacolon, a perforation in your bowel, primary sclerosing cholangitis, colorectal cancer, and heart disease.
UC is a chronic condition that, for most people, requires lifelong treatment, and the only way to cure the condition is by having surgery to remove your colon and rectum.
Ulcerative colitis (UC) is a lifelong condition that you need to manage. It's not deadly on its own, but it is a serious disease that can cause some dangerous and potentially life threatening complications, especially if you don't get the right treatment.
UC is one form of inflammatory bowel disease (IBD). It causes inflammation in the inner lining of your rectum and your large intestine (also known as your colon). The other type of IBD, Crohn's disease, can affect any part of your digestive tract.
When you have UC, your immune system mistakenly attacks your intestines, and these attacks lead to inflammation and sores, or ulcers, in your intestines.
Treatments are available for UC. Most people with UC have a full life expectancy. However, according to one 2003 Danish study, complications can increase the risk of an early death.
Ulcerative colitis complications
While UC itself usually isn't fatal, some of its complications can be.
Potentially serious health complications that can result from UC include:
toxic megacolon
a perforation (hole) in your bowel
primary sclerosing cholangitis
colorectal cancer
heart disease
Toxic megacolon
The most serious possible complication related to UC is toxic megacolon, which is swelling of your colon that can cause it to rupture. This condition affects up to 10% of people with UC.
Some studies show that the death rate among people hospitalized with toxic megacolon is around 6.5%. However, the death rate drops to less than 2% in people with IBD who receive an early diagnosis and prompt medical care.
Bowel perforation
A hole in your bowel is also dangerous. Bacteria from your intestine can get into your abdomen and cause a potentially life threatening infection called peritonitis.
Primary sclerosing cholangitis
Primary sclerosing cholangitis is another rare but serious complication of UC. It causes swelling and damage around your liver and in your bile ducts, which carry digestive fluid from your liver to your intestines.
Scars can form and narrow your bile ducts, and this can eventually cause severe liver damage. In time, you can develop serious infections and liver failure. These conditions can be life threatening.
Colorectal cancer
According to a 2001 research review, people with UC have up to an 8% chance of developing colorectal cancer within 20 years of their UC diagnosis. In comparison, the review noted that the risk among the larger population was 3% to 6%.
More recently, a 2023 review article noted that rates of colorectal cancer among people with UC are decreasing but are still higher than the rates in the larger population.
Colorectal cancer can be fatal if it spreads to other parts of your body.
Heart conditions
According to a 2022 study, UC is associated with a greater risk of heart conditions, including coronary artery disease, heart failure, and atrial fibrillation. And a 2023 study suggests that people with IBD are at a higher risk of death from these types of heart conditions.
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There is a massive disconnect here, and it's very unusual for a company as stable as UNH to deviate so much from its fair value estimate. Valuation multiples are also telling the same story. The forward P/E of this stock is 13.42, which is much lower than the average of 17.66, giving a discount of 23.98%. The company's forward EV/EBITDA of 9.61 is better than the sector's ratio of 11.79. On a price-to-sales ratio, UNH is trading at 0.61 times its projected sales, while the healthcare industry is pricing in at 3.43xa discount of 82%. All in all, UNH gives you both quality and value. Almost all of the valuation measures suggest that the company is undervalued in terms of its earnings, sales, and cash flow. Even though the stock is built on solid foundations and pays out more in dividends each year, it still trades at a lower price than its competitors. As a result, long-term investors can take advantage of acquiring a leader in healthcare at a much lower price than its actual value. When measured against companies like Humana (HUM, Financial) and HealthEquity (HQY, Financial), UnitedHealth Group is still a good buy. Because its forward P/E is lower than HUM's 14.1 times and much lower than HQY's 30 times, it attracts those who want to invest for growth as well as value. Considering price-to-sales, UNH trades at 0.68 times, making it more valuable than HQY's 7.8 while being slightly higher than HUM's very low 0.23. On the EV/EBITDA ratio, UNH stands at 9.6x forward, quite similar to HUM's 9.2x and much less than HQY's 19.2x. All in all, UNH is well-balanced by giving investors scale, profits, dividend growth, and a reasonably attractive price. HUM also does well in various areas, especially when it comes to managing expenses and the way the company works. But in the long run, investors admire UNH for its consistent results and potential to increase. Source: Author generated based on data Going forward, I feel UnitedHealth Group (NYSE:UNH) is well-positioned to achieve a price target of $395$410 in the next year and possibly surpass $525$550 by 2027. Despite the stock's recent volatility, the numbers, the company's health, and the outlook seem to fit together nicely. Let's begin our discussion with the short term. Despite many years of increasing earnings and a high rate of cash conversion, UNH is only valued at 13.4 times its future earnings when the stock is trading at $303. Healthcare companies, on the other hand, have a forward P/E of about 17.6, and UNH has generally had a forward P/E between 18x and 20x during calm times. If UNH is valued at just 17 times the expected FY2025 EPS of $22.59, the price would come to $384. At 18x, If stability comes back and the new leaders reassure everyone, the stock could increase to $406. The story gets even better as you look further into the future. Analysts are predicting that EPS will rise to $45.83 by 2030, meaning it will be about double the current earnings in just five years. Multiply the earnings by 15, and the share price comes out to $687. But, let's narrow our focus to conservatism, and for 2027, the predicted EPS is about $34.50. At this multiple of 15x, the price comes out to $517if the market recovers, shares could climb to $550 or more due to the 16x or 17x rating. If the DOJ investigation ends well and Hemsley's efforts to cut costs are successful, the company should do well over the next few quarters. We are not just discussing theory here. Since 2015, UNH's free cash flow per share has more than tripled, its revenue per share has nearly tripled too, and it still has some of the top dividend growth rates in healthcare. Such consistency, size, and under-valuation are hard to find in one company. Let's look at how Wall Street views this area. Looking at the chart, analysts foresee that the price of Apple shares might rise by 26.2% to $382.80 in the next 12 months. It is estimated that the cost can fall anywhere from $270 to $677. To conclude, although there may be short-term ups and downs, it looks like disciplined, patient investors will find more favorable long-term conditions. When Andrew Witty suddenly left his CEO post in May because of profit problems and dropped 2025 guidance, UNH shares fell over 12% to their lowest point in five years and wiped out more than $250 billion in market value. As a consequence, the board brought back former CEO Stephen Hemsley (who headed the company from 2006 to 2017). Within only a few days, Hemsley made a big step by buying nearly 86,700 shares worth about $25 million for $288.60 per share. Hemsley, together with the CFO and several directors, voted to keep the company's value high, and shares rose by about 8% the following trading day. What does it imply? It is clear that the management views the falling share price of UNH as a good time to purchase. The fact that Hemsley has invested his money shows how much he believes in the company after all it has achieved. Yet, this is not a case of blind faith: the company is dealing with an ongoing investigation, higher medical costs in Medicare Advantage, and a cyberattack it suffered recently. From a strategic point of view, all this buying in UNH suggests that the company's leaders believe the worst has passed and risks for the stock are low. The guru trading chart has an interesting narrative. Although UnitedHealth's stock has gone down recently, gurus have been buying it more frequently. Many green bars are appearing, both early in 2024 and again later in 2025, showing that some informed investors are looking at the dip as an opportunity to buy instead of a warning sign. This trend can be seen in the investor's stock portfolio. Vanguard is still the biggest shareholder, but it slightly reduced its holdings. I'm also paying attention to Ken Fisher (Trades, Portfolio) , who bought much more, a solid 52%, and Jeremy Grantham (Trades, Portfolio) , who increased his holding by over 7%. Though there is selling and shares are reduced as well, institutions tend to be cautiously upbeat. Even though UnitedHealth's future looks bright, investors should still pay attention to the risks in the near term. The DOJ is currently investigating the business for possible Medicare Advantage fraud, such as upcoding and billing errors, which is a very serious matter that could result in being fined or charged in court. At the same moment, Washington is paying more attention to supervision. Should reforms reduce the inflation of risk scores or Medicare allowance for nurse practitioners, it could affect the profitability of Medicare Advantage. Q1 faced some issues because the higher use of medical services caused the medical loss ratio to increase to around 85%, and Optum is still learning to handle CMS's updated risk model. Because of these pressures, there could be more budget reductions for guidance. However, the bad news appears to be mostly factored into share prices. For careful investors who believe the company will survive, this could present an opportunity to buy long-term. The headlines can be very tempting, but stepping back, it appears that UnitedHealth is still a powerhouse lurking in plain sight. It is the same old stuff but with a different sentiment. The long-term story is still in place with the reinstatement of Stephen Hemsley, a recent insider purchase, and a long history of expertise in Medicaid-managed care and the Optum platform in value-based care. Most of that bad news, including the increases in care costs, and regulatory noise, appears to be reflected in price. Sentiment can change at any minute as long as we hear a resolution to the DOJ investigation, a slowdown in the trend of rising Medicare costs, or upbeat guidance in coming quarters. Any of those may be the spark. In the meantime, the stock is currently trading at one of the most attractive valuations it has seen in years, and the set-up is of the sort long-term investors tend to reflect back on with gratitude. If you are waiting to have a clear picture, you may miss the opportunity. However, to the patient and longer-term investors, this may be one of those times when interceding in soreness results in actual payoff. In other words, this just might be a smart time to lean in and buy the stock. This article first appeared on GuruFocus. Sign in to access your portfolio
Yahoo
an hour ago
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UnitedHealth's Rebound: Hidden Strength or Hiding Weakness?
Recently, UnitedHealth Group (UNH, Financial) has been the subject of many headlines because of DOJ probes, kickback accusations in nursing homes, and a shocking departure of its CEO. In addition, the value of its shares has dropped by almost 50%. Yet, underneath the news, the business is still strong. Health insurance remains important and strong throughout economic downturns and doesn't react to changes in global trade. In the aftermath, a clear development can be noticed as Stephen Hemsley was appointed CEO again and bought a large amount of stock which fueled a quick increase in share prices. Warning! GuruFocus has detected 4 Warning Sign with UNH. This is real conviction. UnitedHealth is focusing more on Medicaid-managed care, widening value-based care with Optum, and looking into growing its business in dual-eligible and long-term care. The company's financials confirm the trend since earnings have quadrupled in ten years, cash flow is strong, and insiders are buying in. In short, UnitedHealth is using the uncertainty to its advantage. Long-term investors may find the current price as an attractive chance to enter a company that has shown lasting and solid growth. UnitedHealth Group is the biggest health insurer in the United States and ranks highly internationally in healthcare. Its two key segments, UnitedHealthcare and Optum, give people health benefits, pharmacy services, data analysis, and healthcare. More than 150 million people are helped by this company, which is continuing to expand by combining operations and offering value-based care. The company provides insurance through commercial, Medicare, and Medicaid markets, and Optum sparks new ideas in care coordination and pharmaceutical services. UnitedHealth is smartly diversified. The company is doing well due to managed care growth, making money from healthcare improvements, and strategically serving top segments thanks to Optum doing the main work. Medicaid managed care expansion capturing state-level shifts: The move of Medicaid recipients from fee-for-service to managed care can bring huge benefits to UnitedHealth. According to industry statistics, UNH and four other large insurers cover over 50% of people in Medicaid-managed care across the nation. So, when several hundred thousand to millions switch plans, it has a huge effect on the company's finances. Since monthly premiums for complex patients in these states are $600$800, New York, Pennsylvania, and Michigan could add hundreds of millions of dollars to their annual premium earnings. Because of its connections with states, UNH is in a good position to win a major share of this revenue. Value-based care & optum scale turning outcomes into profit: Optum, which drives UNH's value-based approach, recorded $253 billion in revenue in 2024, which was 12% higher than the previous year, and $16.7 billion in operating income. Currently, Optum Health works with close to 4.7 million people in value-based contracts and plans to add another 650k in 2025. Focus on patient care and cost savings are the main aims of these models, and UNH supports this. When Optum grows its care coordination and home services, shared-savings revenue plays a bigger role, already bringing in hundreds of millions and capable of much more. High-Value segments target the dual-eligible and long-term care markets: Instead of raising its volume, UNH is focusing on high-paying customer groups, such as those with both Medicare and Medicaid and patients needing long-term care. Dual-eligibles may receive $2,500 monthly, which means each person will get $30,000 annually. Currently, UNH serves about 500k people, but if it could capture just 2 million of the national enrollments, it could earn $45 billion in annual premiums. Vertical integration with optum: Thanks to Optum, UNH has all its services combined, including pharmacy (over 1.62 billion scripts were handled by OptumRx in 2024), care delivery, data analysis, and provider management. Because of this integration, UNH is ahead in long-term care, managing care effectively, reducing expenses, and boosting results, which other organizations don't have. Overall, UnitedHealth is a leader that is making steady earnings now and is prepared to capture the future of healthcare and population wellness. Now, let's investigate the financial side of UnitedHealth Group. The company had good first-quarter earnings, but it sent a cautious message for the coming months. UnitedHealth Group's quarterly revenue of $109.6 billion was $10 billion higher than the same period last year, showing how much both UnitedHealthcare and Optum are growing. While adjusted EPS of $7.20 surpassed $6.91 from the earlier period, the company adjusted its full-year forecast down to expect adjusted EPS of $26.00 to $26.50. So, what leads to this change of tone? While UnitedHealthcare welcomed 780,000 new members, increased use of health services in Medicare Advantage by its customers caused the company's medical costs to increase above expectations. Because more people needed outpatient and physician care, the medical care ratio rose to 84.8%. For healthcare delivery, this is not necessarily an issue, yet it can still hurt business if prices fall short. Meanwhile, Optum Health experienced challenges with a more diverse member group and reduced payments due to less involvement among members in 2024. Even so, Optum achieved a $63.9 billion revenue thanks to its Rx division, which filled 408 million adjusted scripts. UNH is also operating efficiently, with its operating cost ratio now 12.4%, free cash flow at $5.5 billion, and a high 26.8% return on equity. The company also gave $5 billion back to its shareholders. All in all, UNH's basics are solid, but it has to deal with some short-term problems first. UnitedHealth Group has consistently improved its earnings over the years. In the year 2015, diluted earnings per share was only $6.01. Looking at the trailing twelve months, the number has reached $23.88. Over the past decade, the amount has almost quadrupled. It is even more impressive that the growth has been steady over the years. For many years, UnitedHealth kept increasing its profits, demonstrating the power of its varied businesses and strict management. The only major drop in EPS happened in 2024, with the figure reaching $15.51. Although this was an unusual dip in the company's history, it is on track for a solid recovery in 2025, and first-quarter adjusted EPS was $7.20. Looking into the future, analysts believe the trend will not stop. Even though 2025 is, in some ways, a year of recovery with a projected EPS of $22.59, the company's growth kicks in afterward. By 2026, analysts predict EPS will increase to $26.40, and then keep growing at double-digit rates, aiming for $45.83 by 2030. Source: Author generated based on historical data All in all, despite some occasional setbacks, UnitedHealth's future growth is steady, so patient investors are still in a position to be rewarded. The increase in EPS matches the upward trend in revenue per share. It highlights the company's steady growth and increased success. In the year 2015, the company's revenue per share was $162.47. Now, that figure is $443.16 TTM. That's a 170% jump in ten years, which clearly shows the company is making better use of its growth to help shareholders. What's most promising is that this growth keeps happening consistently. Revenue per share has increased year after year and stayed strong through different economic conditions and impacts on the industry. It is a result of the company attracting more members and expanding its main businesses, UnitedHealthcare and Optum. Once more, this trend keeps happening in the future. Revenue forecasts keep going up from $449.81 billion in 2025 to more than $591 billion by 2030. Minor changes in growth do not stop the company from expanding and creating more value for its shareholders. Source: Author generated based on historical data UnitedHealth Group's free cash flow per share is a reliable sign of how well the company is financially and operationally. The amount of free cash flow per share in 2015 was $8.46. Afterward, the company increased this number, reaching $26.82 for the TTM, which is more than three times higher than its value a decade back. What stands out about this growth is that it follows closely in line with the company's earnings trajectory. Therefore, we see that UnitedHealth's profits are being turned into cash that can be used to strengthen the business, cut debt, or be given back to its shareholders. Being that efficient is not common in an industry that relies heavily on capital like healthcare. UnitedHealth Group gives investors a good dividend since the dividend yield is 2.92% and the payout ratio is only 30%, which suggests that dividends could increase in the future. It's worth noting that over the past 5 years, the company has seen a 14.6% growth in its dividend, which tops inflation and profits long-term investors. Through ten years of constant raises, the yield on cost increases to 15.38%. Although UNH is offering a high yield now, low buybacks mean most capital is shared through dividends. UnitedHealth Group looks deeply undervalued right now. According to GuruFocus, the stock is trading about half its worth, as the fair value is $633.16 but it is currently trading at $303.22. There is a massive disconnect here, and it's very unusual for a company as stable as UNH to deviate so much from its fair value estimate. Valuation multiples are also telling the same story. The forward P/E of this stock is 13.42, which is much lower than the average of 17.66, giving a discount of 23.98%. The company's forward EV/EBITDA of 9.61 is better than the sector's ratio of 11.79. On a price-to-sales ratio, UNH is trading at 0.61 times its projected sales, while the healthcare industry is pricing in at 3.43xa discount of 82%. All in all, UNH gives you both quality and value. Almost all of the valuation measures suggest that the company is undervalued in terms of its earnings, sales, and cash flow. Even though the stock is built on solid foundations and pays out more in dividends each year, it still trades at a lower price than its competitors. As a result, long-term investors can take advantage of acquiring a leader in healthcare at a much lower price than its actual value. When measured against companies like Humana (HUM, Financial) and HealthEquity (HQY, Financial), UnitedHealth Group is still a good buy. Because its forward P/E is lower than HUM's 14.1 times and much lower than HQY's 30 times, it attracts those who want to invest for growth as well as value. Considering price-to-sales, UNH trades at 0.68 times, making it more valuable than HQY's 7.8 while being slightly higher than HUM's very low 0.23. On the EV/EBITDA ratio, UNH stands at 9.6x forward, quite similar to HUM's 9.2x and much less than HQY's 19.2x. All in all, UNH is well-balanced by giving investors scale, profits, dividend growth, and a reasonably attractive price. HUM also does well in various areas, especially when it comes to managing expenses and the way the company works. But in the long run, investors admire UNH for its consistent results and potential to increase. Source: Author generated based on data Going forward, I feel UnitedHealth Group (NYSE:UNH) is well-positioned to achieve a price target of $395$410 in the next year and possibly surpass $525$550 by 2027. Despite the stock's recent volatility, the numbers, the company's health, and the outlook seem to fit together nicely. Let's begin our discussion with the short term. Despite many years of increasing earnings and a high rate of cash conversion, UNH is only valued at 13.4 times its future earnings when the stock is trading at $303. Healthcare companies, on the other hand, have a forward P/E of about 17.6, and UNH has generally had a forward P/E between 18x and 20x during calm times. If UNH is valued at just 17 times the expected FY2025 EPS of $22.59, the price would come to $384. At 18x, If stability comes back and the new leaders reassure everyone, the stock could increase to $406. The story gets even better as you look further into the future. Analysts are predicting that EPS will rise to $45.83 by 2030, meaning it will be about double the current earnings in just five years. Multiply the earnings by 15, and the share price comes out to $687. But, let's narrow our focus to conservatism, and for 2027, the predicted EPS is about $34.50. At this multiple of 15x, the price comes out to $517if the market recovers, shares could climb to $550 or more due to the 16x or 17x rating. If the DOJ investigation ends well and Hemsley's efforts to cut costs are successful, the company should do well over the next few quarters. We are not just discussing theory here. Since 2015, UNH's free cash flow per share has more than tripled, its revenue per share has nearly tripled too, and it still has some of the top dividend growth rates in healthcare. Such consistency, size, and under-valuation are hard to find in one company. Let's look at how Wall Street views this area. Looking at the chart, analysts foresee that the price of Apple shares might rise by 26.2% to $382.80 in the next 12 months. It is estimated that the cost can fall anywhere from $270 to $677. To conclude, although there may be short-term ups and downs, it looks like disciplined, patient investors will find more favorable long-term conditions. When Andrew Witty suddenly left his CEO post in May because of profit problems and dropped 2025 guidance, UNH shares fell over 12% to their lowest point in five years and wiped out more than $250 billion in market value. As a consequence, the board brought back former CEO Stephen Hemsley (who headed the company from 2006 to 2017). Within only a few days, Hemsley made a big step by buying nearly 86,700 shares worth about $25 million for $288.60 per share. Hemsley, together with the CFO and several directors, voted to keep the company's value high, and shares rose by about 8% the following trading day. What does it imply? It is clear that the management views the falling share price of UNH as a good time to purchase. The fact that Hemsley has invested his money shows how much he believes in the company after all it has achieved. Yet, this is not a case of blind faith: the company is dealing with an ongoing investigation, higher medical costs in Medicare Advantage, and a cyberattack it suffered recently. From a strategic point of view, all this buying in UNH suggests that the company's leaders believe the worst has passed and risks for the stock are low. The guru trading chart has an interesting narrative. Although UnitedHealth's stock has gone down recently, gurus have been buying it more frequently. Many green bars are appearing, both early in 2024 and again later in 2025, showing that some informed investors are looking at the dip as an opportunity to buy instead of a warning sign. This trend can be seen in the investor's stock portfolio. Vanguard is still the biggest shareholder, but it slightly reduced its holdings. I'm also paying attention to Ken Fisher (Trades, Portfolio) , who bought much more, a solid 52%, and Jeremy Grantham (Trades, Portfolio) , who increased his holding by over 7%. Though there is selling and shares are reduced as well, institutions tend to be cautiously upbeat. Even though UnitedHealth's future looks bright, investors should still pay attention to the risks in the near term. The DOJ is currently investigating the business for possible Medicare Advantage fraud, such as upcoding and billing errors, which is a very serious matter that could result in being fined or charged in court. At the same moment, Washington is paying more attention to supervision. Should reforms reduce the inflation of risk scores or Medicare allowance for nurse practitioners, it could affect the profitability of Medicare Advantage. Q1 faced some issues because the higher use of medical services caused the medical loss ratio to increase to around 85%, and Optum is still learning to handle CMS's updated risk model. Because of these pressures, there could be more budget reductions for guidance. However, the bad news appears to be mostly factored into share prices. For careful investors who believe the company will survive, this could present an opportunity to buy long-term. The headlines can be very tempting, but stepping back, it appears that UnitedHealth is still a powerhouse lurking in plain sight. It is the same old stuff but with a different sentiment. The long-term story is still in place with the reinstatement of Stephen Hemsley, a recent insider purchase, and a long history of expertise in Medicaid-managed care and the Optum platform in value-based care. Most of that bad news, including the increases in care costs, and regulatory noise, appears to be reflected in price. Sentiment can change at any minute as long as we hear a resolution to the DOJ investigation, a slowdown in the trend of rising Medicare costs, or upbeat guidance in coming quarters. Any of those may be the spark. In the meantime, the stock is currently trading at one of the most attractive valuations it has seen in years, and the set-up is of the sort long-term investors tend to reflect back on with gratitude. If you are waiting to have a clear picture, you may miss the opportunity. However, to the patient and longer-term investors, this may be one of those times when interceding in soreness results in actual payoff. In other words, this just might be a smart time to lean in and buy the stock. This article first appeared on GuruFocus. Effettua l'accesso per consultare il tuo portafoglio
