Ulcerative Colitis

Published on 06/06/2015 by admin

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Last modified 06/06/2015

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Chapter 60 Ulcerative Colitis

INTRODUCTION

Description: Ulcerative colitis is an inflammatory bowel disease characterized by an inflammation limited to the mucosa of the large bowel and found primarily in the descending colon and rectum (although the entire colon may be involved). The disease is characterized by intermittent bouts of symptoms interspersed by periods of quiescence.

Prevalence: Seventy to 150 in 100,000.

Predominant Age: 20 to 50 years, 20% of patients are younger than 21. (Usually starts between the ages of 15 and 30, and less frequently between 50 and 70 years of age).

Genetics: Family history present in up to 20% (ulcerative colitis or Crohn disease). More common in some ethnic groups (e.g., Jews).

ETIOLOGY AND PATHOGENESIS

Causes: An inflammatory process limited to the mucosa of the large bowel and found primarily in the descending colon and rectum, although the entire colon may be involved. Genetic, infectious, immunologic, and psychologic factors have been postulated to underlie the process.

Risk Factors: Family history. Negatively related to smoking.

CLINICAL CHARACTERISTICS

Signs and Symptoms

• Abdominal pain (generally mild to moderate; the pain is frequently relieved by a bowel movement, but many report the sensation of incomplete evacuation)

• Diarrhea (voluminous, watery, with occasional blood)

• Fever and weight loss

• Arthralgias and arthritis (15% to 20%)

• Aphthous ulcers of the mouth (5% to 10%)

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Netters Obstetrics and Gynecology