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General Medicine

Ulcerative Colitis

Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Chronic relapsing and remitting inflammatory disease of the bowel causing recurrent episodes of diarrhea that is often bloody and accompanied by abdominal pain, incontinence, fever, ...

DIAGNOSIS

HISTORY

  • Frequent diarrhea, may be bloody or include mucus

  • Frequent, small bowel movements, associated with tenesmus, colicky abdominal pain, urgency, and fecal incontinence

  • Onset is gradual and...

TREATMENT

Treatment strategies are determined by functional status, degree of colonic involvement, course of illness, frequency of relapses, extraintestinal manifestations, response to prior treatment...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Regular surveillance colonoscopy in patients with prolonged (8 to 10 years) active disease (2)

  • Initiate annual surveillance immediately in patien...

REFERENCES

1
Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology.  2012;142(1):46....

ADDITIONAL READING

LeBlanc K, Mosli MH, Parker CE, et al. The impact of biological interventions for ulcerative colitis on health-related quality of life. Cochrane Database Syst Rev.  2015;22(9):...

CODES

ICD10

  • K51.90 Ulcerative colitis, unspecified, without complications

  • K51.919 Ulcerative colitis, unspecified with unspecified complications

  • K51.80 Other ulcerative colitis without complications

  • K51.0...

CLINICAL PEARLS

  • Diffuse, uninterrupted colonic mucosal inflammation

  • Hallmark symptom is bloody diarrhea.

  • Annual or biannual surveillance colonoscopy after 8 to 10 years of colitis due to increased risk ...

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Related Images
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Ulcerative colitis. A section of the colonic mucosa from a patient with active ulcerative colitis shows purulent exudate on the surface, ulceration (center), diffuse inflammation superficial to the muscularis mucosae, and numerous crypt abscesses (arrows).
Ulcerative colitis. A section of the colonic mucosa from a patient with active ulcerative colitis shows purulent exudate on the surface, ul...
FIGURE 68.2 (A) Loss of normal vascular pattern (colonoscopic photo) (B) Contact bleeding (C) Granularity (D) Ulceration and friability (E) Colonic stricture.
FIGURE 68.2 (A) Loss of normal vascular pattern (colonoscopic photo) (B) Contact bleeding (C) Granularity (D) Ulceration and friability (E)...
FIGURE 68.2 (A) Loss of normal vascular pattern (colonoscopic photo) (B) Contact bleeding (C) Granularity (D) Ulceration and friability (E) Colonic stricture.
FIGURE 68.2 (A) Loss of normal vascular pattern (colonoscopic photo) (B) Contact bleeding (C) Granularity (D) Ulceration and friability (E)...
FIGURE 68.2 (A) Loss of normal vascular pattern (colonoscopic photo) (B) Contact bleeding (C) Granularity (D) Ulceration and friability (E) Colonic stricture.
FIGURE 68.2 (A) Loss of normal vascular pattern (colonoscopic photo) (B) Contact bleeding (C) Granularity (D) Ulceration and friability (E)...
FIGURE 68.2 (A) Loss of normal vascular pattern (colonoscopic photo) (B) Contact bleeding (C) Granularity (D) Ulceration and friability (E) Colonic stricture.
FIGURE 68.2 (A) Loss of normal vascular pattern (colonoscopic photo) (B) Contact bleeding (C) Granularity (D) Ulceration and friability (E)...
FIGURE 68.2 (A) Loss of normal vascular pattern (colonoscopic photo) (B) Contact bleeding (C) Granularity (D) Ulceration and friability (E) Colonic stricture.
FIGURE 68.2 (A) Loss of normal vascular pattern (colonoscopic photo) (B) Contact bleeding (C) Granularity (D) Ulceration and friability (E)...
Figure 15-23 The colon in chronic ulcerative colitis. Polypoid islands of intact mucosa are surrounded by mucosal ulcers.
Figure 15-23 The colon in chronic ulcerative colitis. Polypoid islands of intact mucosa are surrounded by mucosal ulcers.
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