IBD - Ulcerative colitis

Question 1

Definition

Answer 1

IBD that primarily affects the large intestine (colon) and rectum. It causes the inner lining of the colon to become inflamed and ulcerated,

Question 2

Aetiology/ causes

Answer 2

The specific cause of inflammatory bowel disease is not known. There seems to be a primary genetic component since the most important independent risk factor is a family history of the disease (8% to 14% of patients).

Potentially autoimmune

Potentially triggered by a viral or bacterial infection

Question 3

Risk factors

Answer 3

Family history

Age (usually diagnosed between ages 15 and 30)

Ethnicity (more common in white people)
Smoking (increases the risk of UC)
Environmental factors (such as pollution and a Western diet)

Question 4

Epidemiology/ Population affected

Answer 4

Main peak incidence between 15 and 30y/o

It affects both males and females equally and usually begins in young adulthood.

The incidence and prevalence of UC have been increasing in recent years.

Question 5

Clinical presentation

Answer 5

Diarrhoea (often containing blood and mucus)
Urgency or tenesmus
Abdominal pain
Malaise
Weight loss
Fever
Joint pain

Question 6

Prognosis

Answer 6

The prognosis during the first decade after diagnosis is often generally good, and most patients go into remission.

Question 7

DDX

Answer 7

Crohn’s disease
IBS
Infectious colitis
Colon cancer
Bacterial/viral gastroenteritis

Question 8

Treatment

Answer 8

Medications (such as aminosalicylates, corticosteroids, immunomodulators, and biologics)

Dietary changes (such as avoiding trigger foods and eating a balanced diet)

Surgery (such as colectomy and ileostomy)

Supportive care (such as counselling and stress management)