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Ulcerative Colitis By Aicha N. Saba MD4

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What is it? Ulcerative colitis is an inflammatory bowel disease that causes long-lasting inflammation and ulcers in your digestive tract. Ulcerative colitis affects the innermost lining (mucosa and submucosa) of your colon and rectum. Symptoms usually develop over time, rather than suddenly.

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Epidemiology In the United States, about 1 million people are affected with ulcerative colitis The prevalence rate is 35-100 cases per 100,000 people. Ulcerative colitis is 3 times more common than Crohn disease Ulcerative colitis is slightly more common in women than in men. Age of onset follows a bimodal pattern, with a peak at 15-25 years and a smaller one at 55-65 years Ulcerative colitis is more common in the Western and Northern hemispheres; the incidence is low in Asia and the Far East.

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Causes

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Risk factors Have a family history of the disease Risk increases if an immediate family member such as a parent, brother, or sister has the disease. Are of Ashkenazi Jewish ancestry.

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Pathophysiology

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Signs and Symptoms The most common symptoms are: recurring diarrhea, which may contain blood, mucus or pus abdominal pain Needing to empty your bowels frequently Extreme tiredness Loss of appetite and weight loss. Weeks or months with very mild or no symptoms (remission), followed by periods where the symptoms are particularly troublesome (flare-ups or relapses)

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Ulcerative Colitis classification The severity of UC can be graded as follows: Mild: Bleeding per rectum, fewer than 4 bowel motions per day Moderate: Bleeding per rectum, more than 4 bowel motions per day Severe: Bleeding per rectum, more than 4 bowel motions per day, and a systemic illness with hypoalbuminemia (< 30 g/L)

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Complications Life-threatening complications Severe diarrhea and electrolyte derangements Massive hemorrhage Severe colonic dilation (toxic megacolon) with potential of perforation with peritonitis Higher risk for Colon cancer

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Exams and tests Blood tests: to check for anemia or to check for signs of infection. Stool sample. White blood cells in your stool can indicate ulcerative colitis. Can also help rule out other disorders. Colonoscopy. to view your entire colon. Can also take a biopsy for laboratory analysis. X-ray. If severe symptoms, standard X-ray can rule out serious complications, such as a perforated colon. CT scan of abdomen or pelvis may be performed if a complication from ulcerative colitis suspected. A CT scan may also reveal how much of the colon is inflamed.

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Treatment

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Work cited Clinic, Mayo. http://www.mayoclinic.org/diseases- conditions/ulcerative-colitis/basics/tests-diagnosis/con-20043763. 09 September 2014. 09 March 2015. Medscape. http://emedicine.medscape.com/article/183084- overview#aw2aab6b2b4aa. 14 November 2014. 09 March 2015. Staff, Healthwise. http://www.webmd.com/ibd-crohns- disease/ulcerative-colitis/ulcerative-colitis-what-happens. 08 October 2012. 09 March 2015.