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
