Ulcerative colitis

Question 1

Symptoms

Answer 1

Bloody diarrhoea 
Weight loss
Fatigue
Anaemia 
Cramping pain in LL quadrant

Question 2

Epidemiology

Answer 2

Most common IBD 
Incidence = 10 per 100,000 annually
Prevalence = 243/100,000
Often appears aged 15-25 
More common in caucasian + Ashkenazi Jew

Question 3

Pathophysiology

Answer 3

Mix of genetic susceptibility + enviro
Autoimmune - T cells destroy epithelium. Some patients have P-ANCAs (ABs to own neutros) - thought to come from reaction to gut bacteria similar to our own cells so can cross react
Patients often have increased gut bacteria that produce sulphides + sulphide production linked to flare ups

Question 4

Characteristics

Answer 4

Circumfential + continuous 
No granulomas 
Colon affected + starts at anus 
Ulcers in mucosa/submucosa 
Auto-immune
No strictures + fissures

Question 5

Treatment

Answer 5

Aminosalicyclate for flare ups + maintenance. Can use steriod for flare up
Diet doesn’t effect
Surgery: Subtotal colectomy - ileum joins stoma
IPPA - end of SI joins anus so no stoma