Ulcerative Colitis

Question 1

Aetiologies?

Answer 1

Environmental vs Genetic triggers

Largely unknown

Question 2

Pathology?

Answer 2

Chronic inflammation of the large bowel, appendix or rectum due to prolonged activation of mucosal immune system vs normal gut flora

Question 3

Epidemiology?

Answer 3

Males more than females

Peak ages 20-30, 70-80

Question 4

Signs and Symptoms?

Answer 4

Diarrhoea +/- blood/mucous, Abdominal cramps, Fevers, Malaise, Anorexia, Weight loss
Acute/severe: pyrexia, tachycardia, abdominal tenderness/distension
Clubbing, ulcers, erythema nodsum, infections

Question 5

Investigations and Findings?

Answer 5

Colonoscopy + biopsy - continuous lesion, non-granulomatous inflammation, pseudopolyps
FBC - Decreased Hb
Biochem - raised ESR, decreased albumin

Question 6

Management?

Answer 6

Mild: steroids and 5-ASA po/enema
Moderate: higher dose
Severe: hospital –> IV fluids, high dose steroids, biologics
Protocolectomy/terminal ileostomy if no response to medication/perforation/haemorrhage

Question 7

Complications?

Answer 7

Haemorrhage
Perforation
Toxic Dilation
Colonic cancer