Ulcerative Colitis

Descriptive text is not available for this imageBASICS

DESCRIPTION

Ulcerative colitis (UC) is a chronic, relapsing inflammatory bowel disease (IBD) characterized by continuous inflammation of the colorectal mucosa. It commonly starts in the rectum and may extend proximally, involving the whole colon with a range of symptoms including abdominal pain, rectal bleeding, urgency, diarrhea, and systemic symptoms.

EPIDEMIOLOGY

  • 15–20% of patients with UC present before the age 18 years.
  • Compared with adults, children with IBD are more likely to present with extensive intestinal involvement and have rapid clinical progression.
  • Males and females are equally affected.

ETIOLOGY

The etiology is not completely understood, but it is hypothesized to be the result of a dysregulated immune response to commensal and/or pathogenic organisms in genetically susceptible hosts.

RISK FACTORS

  • Appendicectomy for proven appendicitis before adulthood
  • Smoking is associated with reduced risk and severity of UC.

Genetics

  • 200 independent loci have been identified as potential susceptibility for development of UC. Many are involved in innate or adaptive immune response, antigen sampling, and mucosal barrier functions.
  • A family history of UC or Crohn disease increases the risk for developing UC.

COMMONLY ASSOCIATED CONDITIONS

  • Primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) are hepatobiliary diseases associated with UC.
  • Patients with UC and PSC have a high risk of colon cancer and need to have annual surveillance colonoscopy.

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