Ulcerative Colitis

Ulcerative Colitis

Pathology:                Continuous inflammation from rectum and extending proximally, shallow ulceration, crypt abscesses and goblet cell depletion


Aetiology:                 Unknown, increased incidence in those with relatives with IBD, decreased incidence in smokers


Symptoms:               Bloody diarrhoea, malaise, urgency


Signs:                          Abdominal tenderness


Investigations:      Bloods: FBC shows anaemia, reduced Ferritin, raised CRP / ESR, LFTs

Microbiology: Stool cultures

Imaging: Abdominal X-Ray may show toxic dilatation

  Colonoscopy shows continuous erythematous mucosa, shallow ulcers


Treatment:              Medical: Steroids to induce remission, 5-aminosalicylates (mesalazine) orally or

 topically, azathioprine is used as a steroid sparing agent

Surgical: Colectomy in resistant disease and toxic dilatation


Complications:      Toxic dilatation (transverse colon > 5.5cm), perforation, malignancy, primary sclerosing cholangitis.


Prognosis:                20-30% with pancolitis have a colectomy























Figure 3.5 KeyFeatures In UlcerativeColitis




















































Figure 3.6 Crohn’s Disease Vs. Ulcerative Colitis














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