Ulcerative colitis



Ulcerative colitis





An inflammatory condition that affects the surface of the colon, ulcerative colitis causes friability and erosions with bleeding. The disease usually begins in the rectal area and may extend through the entire bowel. Less frequently, it extends into the splenic flexure, or more proximally extends upward into the entire colon. It rarely affects the small intestine, except for the terminal ileum.

Severity ranges from a mild, localized disorder to a fulminant disease that may lead to a perforated colon, progressing to peritonitis and toxemia.


Causes

Although the etiology of ulcerative colitis is unknown, it’s thought to be related to an autoimmune response. Stress is no longer thought to be a cause. However, it may precipitate or increase the severity of the attack.

Ulcerative colitis occurs primarily in young adults, especially women; it’s also more prevalent among the Jewish population and individuals in higher socioeconomic groups. Onset of symptoms seems to peak in the 15- to 30-year-old age-group, with another peak occurring in the 50- to 70-year-old age-group.


Signs and symptoms

The hallmark of ulcerative colitis is bloody diarrhea. The intensity of these attacks varies with the extent of inflammation. Patients with mild to moderate disease may experience five or fewer bowel movements per day with intermittent bleeding and mucus production. Individuals may experience left lower quadrant pain relieved by defecation, along with fecal urgency and tenesmus. Patients with more severe disease will have more than five bowel movements per day, which may result in anemia, hypovolemia, and impaired nutrition. Extracolonic manifestations also may be present, including erythema nodosum, pyoderma gangrenosum, episcleritis, thromboembolic events, and arthritis.

Ulcerative colitis may lead to complications affecting the following organs and systems:



  • Blood: anemia from iron deficiency, coagulation defects due to vitamin K deficiency


  • Skin: erythema nodosum on the face and arms; pyoderma gangrenosum on the legs and ankles


  • Eye: uveitis


  • Liver: pericholangitis, sclerosing cholangitis, cirrhosis, possible cholangiocarcinoma


  • Musculoskeletal: arthritis, ankylosing spondylitis, loss of muscle mass


  • GI: strictures, pseudopolyps, stenosis, and perforated colon, leading to peritonitis and toxemia.




Diagnosis

Jun 16, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Ulcerative colitis
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