Ulcerative Colitis

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Ulcerative Colitis

A. Description

Ulcerative colitis is an autoimmune disorder that, along with Crohn’s disease, is referred to as inflammatory bowel disease (IBD). IBD is characterized by diarrhea (up to 20 stools during acute exacerbation), crampy abdominal pain, and exacerbations (“flare-ups”)/remissions.

B. Pathophysiology

Ulcerative colitis usually starts in the rectum and moves in a continual fashion toward the cecum. Although there is sometimes mild inflammation in the terminal ileum, ulcerative colitis is a disease of the colon and the rectum. The inflammation and ulcerations occur in the mucosal layer, the inner-most layer of the bowel wall. Since it does not extend through all bowel wall layers, fistulas and abscesses are rare. Water and electrolytes cannot be absorbed through inflamed mucosa. Diarrhea with large fluid and electrolyte losses is a characteristic feature of damage to the colonic mucosa epithelium. Breakdown of cells results in protein loss through stool. Areas of inflamed mucosa form pseudo-polyps, tongue-like projections into the bowel lumen.

C. Common signs & symptoms or clinical manifestations

The common signs of ulcerative colitis include diarrhea, bloody stools, weight loss, abdominal pain, fever and fatigue. It is considered a chronic disorder a chronic disorder with mild to severe acute exacerbations that occur at unpredictable intervals over many years. The primary manifestations of ulcerative colitis are bloody diarrhea and abdominal pain. Pain may vary from the mild lower abdominal cramping associated with diarrhea to the severe, constant pain associated with acute perforations. With mild disease, diarrhea may consist of one to two semi formed stools daily that contain small amounts of blood. The patient may have no other manifestations. In moderate disease there…...

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