Ulcerative Colitis Flashcards
What is ulcerative colitis?
A recurrent inflammatory and ulcerating condition involving the mucosa of the colon
What is happening to the incidence of ulcerative colitis over the last 20 years?
Increasing incidence
Is ulcerative colitis more or less common that Crohn’s disease in children?
Less common
What is a theory as to the aetiology of ulcerative colitis?
Colonic bacteria causing inflammation in the GI tract
What is the presentation of ulcerative colitis?
Bloody diarrhoea Colicky abdo pain Urgency/tenesmus Weight loss/growth failure (although less common than in Crohn's) Malaise, fever etc. Extra-intestinal manifestations Abdo tenderness
What are the extra-intestinal manifestations of ulcerative colitis?
Erythema nodosum
Arthritis
What are the investigations for ulcerative colitis?
Bloods - FBC, electrolytes, CRP, ESR
Faecal calprotectin
Stool samples
Endoscopy
What is the role of faecal calprotectin in the investigation of ulcerative colitis?
Detects colonic inflammation and helps to confirm need for referral
What is the role of a stool sample in the investigation of ulcerative colitis?
To exclude infective causes
What findings on endoscopy would suggest a diagnosis of ulcerative colitis?
Confluent colitis of variable length
Mucosal inflammation
Crypt damage
Ulceration
What % of children have pancolitis?
90%
How is Crohn’s excluded in ulcerative colitis?
Small bowel imaging
What are the management options for ulcerative colitis?
Mesalazine Steroids Immunosuppressants Biologic agents Surgery
What is 1st line for inducing and maintaining remission of ulcerative colitis and how is it taken?
Mesalazine
Taken topically or orally
What is an example of a steroid used in ulcerative colitis and when is it used?
Prednisolone
To induce remission if no response to mesalazine within 4 weeks
What is an example of an immunomodulatory therapy and when is it used in ulcerative colitis?
Azathioprine
To induce remission after acute exacerbations
To maintain remission if not achieved
What is an example of a biologic agent and when is it used in ulcerative colitis?
Infliximab
In patients with resistant disease
What surgery is used to manage ulcerative colitis and what is its role?
Colectomy w/ ileostomy/ileorectal pouch
Curative (because UC is confined to the colon)
What % of ulcerative colitis patients will end up having surgery?
30%
What are the complications of ulcerative colitis?
Colorectal cancer Toxic megacolon (toxic meganostril)
What is the risk of colorectal cancer with ulcerative colitis?
1 in 200 risk for each year of disease between 10-20 years from diagnosis
What is the prognosis of ulcerative colitis?
Variable due to the unpredictable relapses and remission
Lifelong condition
