Ulcerative colitis
| Ulcerative colitis | |
|---|---|
| Endoscopic image of a colon affected by ulcerative colitis. The internal surface of the colon is blotchy and broken in places. Mild-moderate disease. | |
| Specialty | Gastroenterology |
| Symptoms | Abdominal pain, diarrhea mixed with blood, weight loss, fever, anemia,[1] dehydration, loss of appetite, fatigue, sores on the skin, urgency to defecate, inability to defecate despite urgency, rectal pain[2] |
| Complications | Megacolon, inflammation of the eye, joints, or liver, colon cancer[1][3] |
| Usual onset | 15–30 years or >60 years[1] |
| Duration | Long term[1] |
| Causes | Unknown[1] |
| Diagnostic method | Colonoscopy with tissue biopsies[1] |
| Differential diagnosis | Dysentery, Crohn's disease, ischemic colitis[4] |
| Treatment | Dietary changes, medication, surgery[1] |
| Medication | Sulfasalazine, mesalazine, steroids, immunosuppressants such as azathioprine, biological therapy[1] |
| Frequency | 2–299 per 100,000[5] |
| Deaths | 47,400 together with Crohn's (2015)[6] |
Ulcerative colitis (UC) is one of the two types of inflammatory bowel disease (IBD), with the other type being Crohn's disease.[1] It is a long-term condition that results in inflammation and ulcers of the colon and rectum.[1][7] The primary symptoms of active disease are abdominal pain and diarrhea mixed with blood (hematochezia).[1] Weight loss, fever, and anemia may also occur.[1] Often, symptoms come on slowly and can range from mild to severe.[1] Symptoms typically occur intermittently with periods of no symptoms between flares.[1] Complications may include abnormal dilation of the colon (megacolon), inflammation of the eye, joints, or liver, and colon cancer.[1][3]
The cause of UC is unknown.[1] Theories involve immune system dysfunction, genetics, changes in the normal gut bacteria, and environmental factors.[1][8] Rates tend to be higher in the developed world with some proposing this to be the result of less exposure to intestinal infections, or to a Western diet and lifestyle.[7][9] The removal of the appendix at an early age may be protective.[9] Diagnosis is typically by colonoscopy, a type of endoscopy, with tissue biopsies.[1]
Several medications are used to treat symptoms and bring about and maintain remission, including aminosalicylates such as mesalazine or sulfasalazine, steroids, immunosuppressants such as azathioprine, and biologic therapy.[1] Removal of the colon by surgery may be necessary if the disease is severe, does not respond to treatment, or if complications such as colon cancer develop.[1] Removal of the colon and rectum generally cures the condition.[1][9]
- ^ a b c d e f g h i j k l m n o p q r s t u Cite error: The named reference
NIH2014was invoked but never defined (see the help page). - ^ "Ulcerative Colitis". Autoimmune Registry Inc. Archived from the original on 29 October 2018. Retrieved 15 June 2022.
- ^ a b Wanderås MH, Moum BA, Høivik ML, Hovde Ø (May 2016). "Predictive factors for a severe clinical course in ulcerative colitis: Results from population-based studies". World Journal of Gastrointestinal Pharmacology and Therapeutics. 7 (2): 235–241. doi:10.4292/wjgpt.v7.i2.235. PMC 4848246. PMID 27158539.
- ^ Runge MS, Greganti MA (2008). Netter's Internal Medicine E-Book. Elsevier Health Sciences. p. 428. ISBN 9781437727722.
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GBD2015Dewas invoked but never defined (see the help page). - ^ a b Cite error: The named reference
BMJ2013was invoked but never defined (see the help page). - ^ Akiho H, Yokoyama A, Abe S, Nakazono Y, Murakami M, Otsuka Y, et al. (November 2015). "Promising biological therapies for ulcerative colitis: A review of the literature". World Journal of Gastrointestinal Pathophysiology. 6 (4): 219–227. doi:10.4291/wjgp.v6.i4.219. PMC 4644886. PMID 26600980.
- ^ a b c Cite error: The named reference
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