Ulcerative Colitis

• Inflammation of mucosa and submucosa with abscess formation; homogenous mucosal inflammation, continuous
• Extends from rectum proximally (classically); spares upper GI tract
• Diarrhea: mucous laden bloody stools
• Fever, weight loss, anorexia
• Possible extra-intestinal manifestations:
  • GI related (liver): sclerosing cholangitis, chronic active hepatitis
  • Rheum (HLA-B27): ankylosing spondylitis
  • Derm: pyoderma gangrenosum
  • mnemonic: My uncle is not a cronie, he brought a liver pie (not crohns=UC, anklyosing..., liver-related, pie-oderma)
• vs Crohns extraintestinal...
  • GI related (mucocutaneous): oral aphthous ulcers, perianal fistulae
  • Rheumatologic: arthritis, uveitis
  • Derm: erythema nodosum

Labs may include

• anemia (iron deficiency or chronic inflammation)
• low albumin
• elevated ESR.
• ANCA (anti-neutrophil cytoplasmicantibodies) present in 65% of children (only 20% inChron’s)

Radiological findings: loss of haustration; no skip lesions

Despite the name, do not see discrete ulcers (as seen inChron’s)

Treatment aimed at controlling sx and reducing recurrence

• Therapy: aminosalicylate,sulfasalizine, steroids; nutritional support
• surgery (e.g., total colectomy) if refractory to medical txor high grade dysplasia

Risk of cancer increases with time of having disease and with extent of colon involved; should have routine screening colonoscopy for early identification