Ulcerative colitis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Ulcerative colitis (UC) is a type of inflammatory bowel disease characterized by diffuse inflammation of the colonic mucosa and a relapsing, remitting course.
Patients commonly experience bloody diarrhea, chronic diarrhea (or both), lower abdominal pain, fecal urgency, and extraintestinal manifestations, particularly those related to activity of the colitis.
Diagnosis requires endoscopy with biopsy and negative stool culture.
Relapses are often associated with pathogens; therefore, stool should be obtained for culture in all cases of disease flare-up.
Treatment aims to induce and maintain remission. Drug choice and formulation depends on the severity and extent of disease.

Colonic biopsy specimen showing severe mucosal inflammation, formation of crypt abscess, mild glandular atrophy, and distortion, suggesting an active phase of ulcerative colitis; hematoxylin/eosin staining, ×400 magnification

From Iannone F, Scioscia C, Musio A, et al Leucocytoclastic vasculitis as onset symptom of ulcerative colitis Ann Rheum Dis 2003 Aug;62(8):785-6; used with permission

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Colonic biopsy specimen showing severe mucosal inflammation, formation of crypt abscess, mild glandular atrophy, and distortion, suggesting an active phase of ulcerative colitis; hematoxylin/eosin staining, ×400 magnification

Citations

Key Articles

World Gastroenterology Organisation. Global guidelines: inflammatory bowel disease. Aug 2015 [internet publication].[Full Text]
Rubin DT, Ananthakrishnan AN, Siegel CA, et al. ACG clinical guideline: ulcerative colitis in adults. Am J Gastroenterol. 2019 Mar;114(3):384-413.[Abstract]
Feuerstein JD, Isaacs KL, Schneider Y, et al. AGA clinical practice guidelines on the management of moderate to severe ulcerative colitis. Gastroenterology. 2020 Apr;158(5):1450-61.[Abstract][Full Text]
Harbord M, Eliakim R, Bettenworth D, et al. Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 2: current management. J Crohns Colitis. 2017 Jul 1;11(7):769-84.[Abstract][Full Text]
National Institute for Health and Care Excellence (UK). Ulcerative colitis: management. May 2019 [internet publication].[Full Text]

Other Online Resources

CCFA: The Crohn's and Colitis Foundation of America
National Institute of Diabetes and Digestive and Kidney Diseases: ulcerative colitis
American Gastroenterological Association (AGA): GI patient center
Crohn's and Colitis UK

Referenced Articles

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