ULCERATIVE COLITIS

APPLIED MEDICINE
 DEFINITION OF ULCERATIVE COLITIS

Ulcerative colitis is an inflammatory bowel disease

(IBD) that causes long-lasting inflammation and
ulcers (sores) in digestive tract. Ulcerative colitis
affects the innermost lining of large intestine (colon)
and rectum.
The disease can affect people of any age. But most
people who have it are diagnosed before the age of
30.
 Symptoms usually develop over time, rather than
suddenly.
 SIGN AND SYMPTOMS

Signs and symptoms may include:

Diarrhea, often with blood or pus
Abdominal pain and cramping
Rectal pain
Rectal bleeding — passing small amount of blood with stool
Urgency to defecate
Inability to defecate despite urgency
Weight loss
Fatigue
Fever
In children, failure to grow
 TYPES OF ULCERATIVE COLITIS

Proctitis. Inflammation is confined to the area

closest to the anus (rectum), and rectal bleeding may
be the only sign of the disease. This form of
ulcerative colitis tends to be the mildest.
Distal Colitis: Inflammation extends from the
rectum up through the sigmoid and descending
colon. Signs and symptoms include bloody diarrhea,
abdominal cramping and pain on the left side, and
unintended weight loss.
 TYPES OF ULCERATIVE COLITIS

Pancolitis. Pancolitis often affects the entire colon

and causes bouts of bloody diarrhea that may be
severe, abdominal cramps and pain, fatigue, and
significant weight loss.
Extensive colitis. This rare form of colitis affects
the entire colon except ascending colon and causes
severe pain, diarrhea, bleeding, fever and inability to
eat.
 DIAGNOSIS AND INVESTIGATIONS

Blood tests.  Doctor may suggest blood tests to

check for anemia — a condition in which there aren't
enough red blood cells to carry adequate oxygen to
your tissues — or to check for signs of infection.
Stool sample. White blood cells in stool can
indicate ulcerative colitis. A stool sample can also
help rule out other disorders, such as infections
caused by bacteria, viruses and parasites.
 DIAGNOSIS AND INVESTIGATIONS

Colonoscopy. This exam allows doctor to view entire colon

using a thin, flexible, lighted tube with an attached camera.
During the procedure, doctor can also take small samples of
tissue (biopsy) for laboratory analysis. Sometimes a tissue
sample can help confirm a diagnosis.
X-ray. If patient have severe symptoms, doctor may use a
standard X-ray of abdominal area to rule out serious
complications, such as a perforated colon.
CT scan. A CT scan of abdomen or pelvis may be
performed if doctor suspects a complication from ulcerative
colitis. A CT scan may also reveal how much of the colon is
inflamed.
 TREATMENT OF ULCERATIVE COLITIS

Ulcerative colitis treatment usually involves either

drug therapy or surgery.
Anti-inflammatory drugs:
Corticosteroids. These drugs, which include
prednisone and hydrocortisone are generally
reserved for moderate to severe ulcerative colitis that
doesn't respond to other treatments., Due to the side
effects, they are not usually given long term.
 TREATMENT OF ULCERATIVE COLITIS

Other medications:
Antibiotics. People with ulcerative colitis who run
fevers will likely take antibiotics to help prevent or
control infection.
Anti-diarrheal medications. For severe diarrhea,
loperamide (Imodium) may be effective. Use anti-
diarrheal medications with great caution and after
talking with your doctor, because they may increase
the risk of toxic mega colon (enlarged colon).
 TREATMENT OF ULCERATIVE COLITIS

Pain relievers. For mild pain, your doctor may

recommend acetaminophen (Tylenol, others) — but
not ibuprofen (Advil, Motrin IB, others), naproxen
sodium (Aleve), and diclofenac sodium (Voltaren),
which can worsen symptoms and increase the
severity of disease.
Iron supplements. If patient have chronic
intestinal bleeding, he may develop iron deficiency
anemia and be given iron supplements.
 TREATMENT OF ULCERATIVE COLITIS

Surgery can often eliminate ulcerative colitis. But

that usually means removing entire colon and
rectum (proctocolectomy).
Ileac pouch anal anastomosis: This procedure
eliminates the need to wear a bag to collect stool.
Surgeon constructs a pouch from the end of small
intestine. The pouch is then attached directly to
anus, allowing patient to expel waste relatively
normally.
 Complications:

Severe bleeding
A hole in the colon (perforated colon)
Severe dehydration
Liver disease (rare)
Bone loss (osteoporosis)
Inflammation of skin, joints and eyes
An increased risk of colon cancer
A rapidly swelling colon (toxic mega colon)
Increased risk of blood clots in veins and arteries