Ulcerative Colitis

Question 1

Clinical features

Answer 1

Bloody diarrhoea
Colicky abdo pain
Faecal urgency
Tenesmus (continual need to empty bowel)

Question 2

Complications

Answer 2

Growth retardation
Deficiencies
Toxic megacolon
Haemorrhage
Increased risk colon cancer

Question 3

Dietary management

Answer 3

Limited evidence nutrition influences remission
Maintain/restore good nutritional status
No indication for EN as treatment

Low FODMAPS + probiotics discussed but no conclusive evidence

Question 4

Surgical management:

Answer 4

Only cure

Question 5

Surgical management:

Acute severe colitis

Answer 5

Sub-total colectomy
End ileostomy
Preservation of long rectal stump

Question 6

Surgical management:

Elective surgery

Answer 6

Scheduled in advance
IAPP
Panproctocolectomy with permanent end ileostomy

Question 7

Surgical management:

Proctocolectomy

Answer 7

Removed colon + rectum

Permanent ileostomy formed

Question 8

Surgical management:

ileostomy

Answer 8

Damaged part of ileum (end of s intestine) removed + cut end diverted to opening in abdo wall

Question 9

Surgical management:

ileostomy - concerns

Answer 9

Obstruction
Fluid + urea loss
Foods which cause odour
Foods which increase flatulence

low FODMAP may reduce frequency

Question 10

Surgical management:

IAPP

Answer 10

Ileo-anal pouch procedure

Removes colon + rectum
Pouch formed form segment of s intestine attached to anus
Temp ileostomy formed
Secondary surgery connects s intestine to pouch to act as artificial rectum
Bowel movements gradually reduce as pouch adapts