Ulcerative colitis

Features

• Chronic (> 6 months) of bloody diarrhea.
• No infective cause of diarrhea found.
• Inflammatory changes are mainly left sided or in the distal large bowel.
• Disease variable in severity from patient to patient and time to time.
• Significant risk of carcinoma after 10 years, which may in some cases require frequent surveillance biopsies or even prophylactic bowel removal.
• Patients may have other auto-immune features.

Cause

• Unknown
• ? Infection + genetic susceptibility

Diagnosis

• History (long standing diarrhea with blood).
• Exclude infection.
• Biopsy (characteristic biopsy appearance).
• Mainly Left side of colon

Course

1. Intially bloody diarrhea (severity is variable from time to time).
2. Sometimes patients get an extreme diarrheal disease (Toxic megacolon).
3. Eventually the inflamed mucosa develops a risk of malignancy, requiring biopsy every few months.
4. Sometimes the risk of malignancy is such that bowel resection is offered.

Treatment

• Avoid anti-diarrheal drugs unless under specific doctors orders (can worsen disease)
• Anti-inflammatory drugs (Sulfasalazine)
• Steriods in severe cases.

See also: Gastroenterology, Crohn's disease