Ulcerative Colitis

Question 1

What is the definition of UC?

Answer 1

Inflammatory bowel disease characterised by diffuse inflammation of the colonic mucosa and relapsing, remitting course

Question 2

Where does UC affect?

Answer 2

Rectum and extends proximally to affect a variable length of the colon

Question 3

What is the cause of UC?

Answer 3

Autoimmune disease often initiated by an inflammatory response to colonic bacteria

Question 4

What are the risk factors of UC?

Answer 4

Family history

<30

Question 5

How does UC present?

Answer 5

Rectal bleeding, diarrhoea, blood in stool, abdominal pain, arthritis, malnutrition, abdominal tenderness, weight loss, mucus discharge, tenesmus
Erythema nodosum, uveitis, primary sclerosing cholangitis

Question 6

What are the investigations for UC?

Answer 6

Stool culture (-ve), faecal calprotectin (raised), FBC (anaemia), ESR (raised), CRP (raised), AXR (toxic megacolon?) flexible sigmoidoscopy, colonoscopy, biopsy

Question 7

What are the colonoscopy findings in UC?

Answer 7

Mucosal inflammation, crypt abscesses, reduced goblet cells, non-granulomatous, continuous inflammation, pseudopolyps, ulcers

Question 8

What is the management of acute severe UC?

Answer 8

IV corticosteroids high dose, rescue therapy of infliximab if not responding

Question 9

What is the maintenance therapy for UC?

Answer 9

If in remission from infliximab, continue for maintenance

Question 10

What are the complications of UC?

Answer 10

Toxic megacolon, perforation, infection, colonic adenocarcinoma, inflammatory pseudopolyps