Ulcerative Colitis Flashcards
What is proctitis?
UC of rectum
Which layer/layers of the GI tract does UC affect?
Mucosa
Which parts of the GI tract are affected in UC?
Rectum, colon and occasionally the terminal ileum
What is the main test for IBD?
Faecal calprotectin
What is faecal calprotectin?
Marker of intestinal inflammation
Distinguishes IBD and IBS
What is the diagnostic investigation of choice in UC?
Colonoscopy
Sigmoidoscopy can be used also
What macroscopic findings are seen on a colonoscopy in UC? (5)
• Continuous, uniformly inflamed mucosa
• Erythematous, friable mucosa
• Abnormal vascular pattern
• Ulceration
• Inflammatory polyps (‘pseudopolyps’)
What microscopic findings are seen on biopsy in UC? (2)
• Crypt abscesses
Decreased goblet cell abundance
What is the main symptom of UC?
Bloody diarrhoea/rectal bleeding
What pneumonic can be used to remember features and treatment of UC? (7)
CLOSE UP
Continuous inflammation (no skip lesions)
Limited to colon + rectum
Only superficial mucosa
Smoking is protective
Excrete blood and mucus
Use aminosalicylates
Primary sclerosing cholangitis
What are some extra-colonic manifestations of UC? (8)
Arthritis
Uveitis
Aphthous ulcers
Erythema nodosum
Fatty liver disease
Autoimmune liver disease
Anaemia
Thromboembolism
What is the 1st line treatment to induce remission in UC?
Aminosalicylates e.g. mesalazine
What is the second line treatment for inducing remission in UC?
Steroids e.g. 40mg prednisolone
When are maintenance therapies given in UC? (3)
People who fail to respond to remission therapy, have 2 or more flares within a 12 month period or those who are steroid dependent
Which drugs are used in maintenance therapy in UC? (2)
Thiopurines (Azathioprine + mercaptopurine)
Bilogics e.g. moniclonal antibodies e.g. infliximab/adalimumab
