Definition of Ulcerative Colitis

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Definition of Ulcerative colitis “Ulcerative colitis (UC) is a non-specific inflammatory condition of the colon”(Porth, 2007). UC is one of the two main forms of chronic inflammatory disease of the gastrointestinal tract; called inflammatory bowel disease (IBD) .The disease may involve the rectum alone (ulcerative proctitis); the rectum and the sigmoid colon (proctosigmoiditis) or the entire colon (pancolitis) Etiology of Ulcerative colitis The etiology of ulcerative colitis is unknown. Many the
  Definition of Ulcerative colitis “ Ulcerative colitis (UC) is a non-specific inflammatory condition of the colon ”(Porth, 2007) . UCis one of the two main forms of chronic inflammatory disease of the gastrointestinal tract; calledinflammatory bowel disease (IBD) .The disease may involve the rectum alone (ulcerativeproctitis); the rectum and the sigmoid colon (proctosigmoiditis) or the entire colon (pancolitis) Etiology of Ulcerative colitis The etiology of ulcerative colitis is unknown. Many theories have been developed in an attemptto explain this health condition. Ulcerative colitis is believed to be multifactorial where proposedcauses include environmental factors, immune dysfunction, and genetic predisposition1. Environmental factors    Diet : Intake of unhealthy food and low-residue high-refined sugar have been consideredto be contributory factors in the development of ulcerative colitis    Infections : Some researchers feel that ulcerative colitis may be related to certaindigestive infections caused by the microorganism E. Coli. It is also believed that modernmeasles virus, improperly cleared from the body, results in low grade, chronicinflammation of the intestinal lining.    Drugs : Studies have linked the intake of oral contraceptive pill, antibiotics and otherdrugs to the development Ulcerative colitis. E.g. Isotretinoin, a commonly used drug forsevere acne is found to trigger UC in some patients.  2.   Immune dysfunction      Disturbances of the immune system : Some experts believe that there may be a defect in one’s immune system responsible for ongoing inflammation in the intestinal wall.    Allergy : Some studies suggest that Ulcerative colitis is a form of exaggerated allergicresponse to certain food or to the presence of some microorganisms present in theintestine.    Autoimmune disease : Most recent research indicate that ulcerative colitis can be a form of autoimmune disease in which body’s defense system starts attacking body’s own organs and tissues. 3. Genetics  Current research suggests that certain genetic factors may increase the likelihood of personhaving Ulcerative colitis. If someone’s immediate family members has ulcerative colitis, then one’s chances of having the disease increases.  Pathophysiology Macroscopically, most cases of UC arise in the rectum, with some patients developing terminalileitis. The bowel wall is thin or of normal thickness, but the presence of edema, theaccumulation of fat, and hypertrophy of the muscle layer may give the impression of a thickenedbowel wall. Microscopically, UC involves only the mucosa, with the formation of cryptabscesses and a coexisting depletion of goblet cell mucin. In severe cases, the submucosa can beinvolved, and in some cases, the deeper muscular layers of the colonic wall can also be affected.Further microscopic changes include inflammation of the crypts of Lieberkuhn and abscesses.Ulcerated areas are soon covered by granulation tissue. The undermined mucosa and; the excessgranulation tissue form polypoidal mucosal excrescences. These are known as inflammatorypolyps or pseudopolyps. Signs and symptoms The clinical presentation   of ulcerative colitis depends on the extent of the disease process. Theymay come on suddenly or develop gradually.The three classic symptoms of ulcerative colitis are:    Persistent or recurrent diarrhea (in ulcerative colitis this diarrhea is often bloody or fullof mucus)    Abdominal pain (which in ulcerative colitis is often crampy in nature and most intenseimmediately before a bowel movement)    Fever (Ulcerative colitis is an inflammatory disease, and one of the key characteristics of the inflammatory process is fever (the others being pain, heat, and redness). Some  individuals with ulcerative colitis suffer a high fever, especially during the acute phase of a flare-up. Others run a persistent, low-grade fever)Other symptoms may include: peri-anal irritation, fissures, hemorrhoids, fistulas, abscesses,fatigue, weight loss and loss of appetiteAdditionally, since ulcerative colitis is associated with the general inflammatory process somesymptoms of this disorder are manifested in other systems of the bodyAmong these are:    Reddening and inflammation of the eye (iritis)    Joint pains, usually in the large joints of the knees, ankles, elbows, wrists, and shoulders,which sometimes migrate from one joint to another (migrating arthralgia)    Skin lesions including tender red nodules on the shins or calves (erythma nodosum)    Sores inside the mouth (aphthous ulcers) Diagnosis The initial diagnostic workup for ulcerative colitis includes the following:    A complete blood count is done to check for anemia    Electrolyte studies and renal function tests are done, as chronic diarrhea may beassociated with hypokalemia, hypomagnesmia and pre-renal failure.    Liver function tests are performed to screen for bile duct involvement.    X- ray    Urinalysis Stool culture, to rule out parasites and infectious causes.
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