Ulcerative colitis
Medicine > Gastroenterology > Ulcerative colitis
Ulcerative Colitis
Features:
- Chronic (> 6 months) of bloody diarrhea.
- No infective cause of diarrhea found.
- Inflammatory changes are mainly left sided or in the distal large bowel.
- Disease variable in severity from patient to patient and time to time.
- Significant risk of carcinoma after 10 years, which may in some cases require frequent surveillance biopsies or even prophylactic bowel removal.
- Patients may have other auto-immune features.
Cause
- Unknown
- ? Infection + genetic susceptibility
See Crohn's Disease
Diagnosis.
- History (long standing diarrhea with blood).
- Exclude infection.
- Biopsy (characteristic biopsy appearance).
- Mainly Left side of colon
Course
- Intially bloody diarrhea (severity is variable from time to time).
- Sometimes patients get an extreme diarrheal disease (Toxic megacolon).
- Eventually the inflamed mucosa develops a risk of malignancy, requiring biopsy every few months.
- Sometimes the risk of malignancy is such that bowel resection is offered.
Treatment
- Avoid anti-diarrheal drugs unless under specific doctors orders (can worsen disease)
- Anti-inflammatory drugs (Sulfasalazine)
- Steriods in severe cases.