Ulcerative Colitis Flashcards
What is ulcerative colitis?
Ulcerative colitis is an inflammatory bowel disease (IBD) that causes inflammation and ulcers in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine and rectum. Symptoms usually develop over time, rather than suddenly.
What part of the GI is inflamed in UC?
Ulcerative colitis can affect the rectum alone (proctitis), can extend proximally to involve the sigmoid and descending colon (left-sided colitis), or may involve the whole colon (extensive colitis)
What is proctitis?
Ulcerative colitis of the rectum
What is left-sides colitis?
Ulcerative colitis of the rectum, sigmoid and descending colon
What is the age of onset for UC?
15-35 and 55-70
How does smoking relate to ulcerative colitis?
Protective factor
What causes ulcerative colitis?
The cause of UC is unknown. Theories involve immune system dysfunction, genetics, changes in the normal gut bacteria, and environmental factors.
What are microscopic changes seen in ulcerative colitis?
- The mucosa shows a chronic inflammatory cell infiltrate in the lamina propria.
- Crypt abscesses
- Goblet cell depletion
What are macroscopic chances seen in ulcerative colitis?
- Mucosa looks reddened and inflamed, it bleeds easily. Inflammation is continuous
- In severe disease, there is extensive ulceration with the adjacent mucosa appearing as inflammatory (pseudo) polyps
What are the symptoms of ulcerative colitis?
The major symptom in UC is diarrhoea with blood and mucus, sometimes accompanied by lower abdominal discomfort
General features:
- Malaise
- fatigue
- Anorexia
- Aphthous ulceration in the mouth
- Tenesmus
What are symptoms specific to proctitis?
Proctitis is characterized by the frequent passage of blood and mucus, urgency and tenesmus. There are normally few constitutional symptoms and the stool when passed, may be solid. Patients are nevertheless greatly inconvenienced by the frequency of defecation.
What is the course of ulcerative colitis?
The disease can be mild, moderate and severe and often runs a course of remissions and exacerbations. Of the patients, 10% have persistent chronic symptoms, while some patients may have only a single attack.
How is ulcerative colitis diagnosed?
Presence of chronic diarrhoea for more than 4 weeks and presence of acute inflammation on endoscopy and chronic changes on biopsy
What would a colonoscopy in ulcerative colitis show?
Endoscopic findings in ulcerative colitis include erythema (redness of the mucosa), friability of the mucosa, superficial ulceration, and loss of the vascular appearance of the colon
Histologic findings in ulcerative colitis includes distortion of crypt architecture, crypt abscesses, and inflammatory cells in the mucosa. Limited inflammation only in mucosa
What are the aims of drug treatment in ulcerative colitis?
- Treat acute attack
2. Prevent relapse