Ulcerative Colitis

What is Ulcerative Colitis?

Ulcerative colitis is an idiopathic inflammatory condition of the colon which results in diffuse friability and superficial erosions on the colonic wall associated with bleeding. The inflammation is characteristically involving inflammation limited to mucosa and submucosa of the colon. The entire pathophysiology of ulcerative colitis involves defects in the epithelial barrier, immune response, leukocyte recruitment, and microflora of the colon.

It is the most common IBD (Inflammatory Bowel Disease) occurring worldwide. Globally, the incidence of IBD is approximately 0.5-24.5 cases per 100,000 person-years for ulcerative colitis. The disease has a bimodal pattern of occurrence.

Aetiology

The exact cause of the disease remains unknown. Genetic component is strongly associated with the development of the disease. A first-degree relative of a patient with ulcerative colitis has a four times higher risk of developing the disease. Autoimmunity also plays a very important role in the pathogenesis of ulcerative colitis. Though studies suggest that smoking is a protective factor for the disease, more studies are required to establish a direct relationship between the two.

Sign and symptoms

The most common symptom is bloody diarrhoea, with or without mucous. Other associated symptoms are:

Urgency or tenesmus
Abdominal pain
Malaise
Weight loss
Fever

10 to 30 percent of the patients present with extraintestinal manifestations which include episcleritis, scleritis and uveitis, peripheral arthropathies, erythema nodosum, and pyoderma gangrenosum.

Diagnosis

The diagnosis of ulcerative colitis is achieved clinically and on the basis of findings on endoscopy, biopsy and by stool examination. Patients with long standing ulcerative colitis may show “stove-pipe” sign on barium enema. 60 to 70 percent of the patients are positive for P-ANCA (perinuclear antineutrophil cytoplasmic antibodies). Multiple biopsies should be obtained to confirm the diagnosis.

General management

Proper pharmacological intervention for the symptomatic relief is recommended.

Warning: Above information provided is an overview of the disease, we strongly recommend a doctor’s consultation to prevent further advancement of disease and/or development of complications.