Ulcerative colitis Flashcards
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Ulcerative colitis is a chronic inflammatory bowel disease (IBD) characterized by inflammation and ulceration of the colonic mucosa.
· It primarily affects the rectum and extends proximally in a continuous manner, potentially involving the entire colon.
patho 3
Immune Dysfunction:
§ Overactive immune responses attack colonic tissue, releasing cytokines (e.g., TNF-α) that cause inflammation and tissue damage.
o Barrier Breakdown:
§ Impaired tight junctions and reduced mucus expose the epithelium to bacteria, leading to further inflammation and ulceration.
o Microbial Dysbiosis:
§ An imbalance in gut bacteria exacerbates immune activation and inflammation.
Symptoms
o Bloody diarrhoea (hallmark), often with mucus.
o Abdominal pain, usually in the lower left quadrant.
o Urgency and tenesmus (incomplete evacuation).
o Frequent loose stools and rectal bleeding.
· Systemic Symptoms:
o Fatigue, fever, weight loss, and anaemia due to inflammation and blood loss.
· Extraintestinal Manifestations:
o Joints: Arthritis.
Diagnosis
Clinical History: Symptoms like bloody diarrhoea, abdominal pain, and urgency.
o Lab Tests: Blood tests for anaemia, inflammation (CRP, ESR); stool tests to rule out infections.
o Endoscopy: Colonoscopy or sigmoidoscopy to examine mucosal inflammation and ulcers, and biopsy for diagnosis.
Treatment
Aminosalicylates (5-ASA): Reduce inflammation.
§ Corticosteroids: For acute flare-ups.
§ Immunosuppressants (e.g., azathioprine, methotrexate): Control immune response.
§ Biologics (e.g., TNF inhibitors like infliximab): Target specific immune pathways.
Prognosis
No Cure: UC is a chronic condition with periods of remission and flare-ups.
o Management: Long-term medication can control symptoms, but no permanent cure exists. Surgery is a potential option for severe cases
