Ulcerative Colitis.png
Colonoscopy showing Ulcerative Colitis

Definition

[1]
Ulcerative Colitis (also UC) is a chronic relapsing inflammatory disorder of the colonic mucosa.

Prevalence

[2]
100-200 per 100 000 lifetime risk.

Age

15-30

Gender

Slightly more likely in Females

Risk Factors

[3]

Signs and Symptoms

[4]

Pathophysiology

[5]
Ulcerative colitis begins in the rectum for most patients. Ulcerative Colitis usually only involves the mucosal layer unlike Crohn's Disease which can be transmural. There is simultaneous depletion of mucin from goblet cells and the formation of crypt abscesses causing ulceration. Ulcerative Colitis usually involves periods on remission and relapse.

Investigations

[6]

Bloods

Imaging

  • Erect Abdominal X-ray - dilated loops of colon, free air if there is perforation
  • Colonoscopy - Continuous involvement, loss of vascular marking, diffuse erythema, mucosal granularity, normal terminal ileum

Other

  • Stool sample - negative for infective agent
  • Colon Biopsy - mucin depletion, mucosal atrophy, absence of granulomas

Diagnosis

[7]
Ulcerative Colitis should be suspected in patients with rectal bleeding and systemic illness lasting more than 3 weeks. Clinical diagnosis should be confirmed with negative stool samples and a colonoscopy.

Differentials to rule out

Treatment

[8]

Non-Pharmacological

  • Fluid resuscitation

Pharmacological

Surgical

  • Colectomy

Management

[9]
Patients with ulcerative colitis are at increased risk of developing colorectal cancer and should be monitored accordingly. Patients should also seek medical attention if symptoms recur.

Complications

[10]

Prognosis

[11]
There is no significantly increased mortality in patients with ulcerative colitis compared to the general population

See Also

Oxford Handbook of Clinical Medicine - 9th edition p272
BMJ Best Practice - Ulcerative Colitis

Citation

Ulcerative Colitis Colonoscopy image: "UC granularity". Licensed under CC BY-SA 3.0 via Commons - https://commons.wikimedia.org/wiki/File:UC_granularity.png#/media/File:UC_granularity.png
  1. ^ Oxford Handbook of Clinical Medicine - 9th edition p272
  2. ^ Oxford Handbook of Clinical Medicine - 9th edition p272
  3. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/43.html
  4. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/43.html
  5. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/43.html
  6. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/43.html
  7. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/43.html
  8. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/43.html
  9. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/43.html
  10. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/43.html
  11. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/43.html