Ulcerative Colitis

Question 1

What is UC?

Answer 1

Inflammation of the left side of colon and rectum

Question 2

What layer of the bowel does it affect?

Answer 2

Superficial Mucosa

Question 3

Continuous or patchy?

Answer 3

Continuous

Question 4

What type of inflammation?

Answer 4

Ulceration with inflammatory polyps and shows inflammatory cell infiltrate in the Lamina Propria

Question 5

What histopathological features are there?

Answer 5

Crypt abscesses and goblet cells

Question 6

Is it common?

Answer 6

Not really, affects 8 per 100,000

Question 7

Risk Factors: (2)

Answer 7

Mutations to genes that control mucosal barrier e.g DRB 0103 allele
Chronic stress and depression

Question 8

Any protective factors?

Answer 8

Smoking and Appendicectomy

Question 9

Symptoms:

Answer 9

Chronic diarrhoea, mucus/blood in stool, cramping abdominal pain, urgency/tenesmus, weight loss, malaise, anorexia

Question 10

Signs:

Answer 10

Tachycardia, tender abdomen, clubbing, Erythema Nodosum

Question 11

Main Differentials (3)

Answer 11

Crohn’s, Gastroenteritis, IBS

Question 12

What blood tests would you do?

Answer 12

FBC, ESR, CRP, U&E, LFT, Blood Culture

Question 13

Other investigations:

Answer 13

Stool sample for faecal elastase, Abdominal x-ray, colonoscopy with biopsy

Question 14

First line treatment

Answer 14

Mesalazine

Question 15

Other treatments (4)

Answer 15

Prenisolone, Hydrocortisone, Ciclosporin/Infliximab therapy, resection of affected bowel

Question 16

Complications (5)

Answer 16

Perforation, haemorrhage, toxic megacolon, risk of colon cancer and osteoporosis