Ulcerative Colitis

Etiology

  • Automimmune
  • Genetic
  • Other
  • Environmentally triggered
  • Affects colonic mucosa, distal to prox

Risk Factors

  • Family history
  • Northen Europeans, North Americans
  • Smoking and appendectomy protective
  • Peak onset 15-30

Symptoms

  • Wt loss
  • Recurrent or chronic diarrhea
  • Sub-acute fatigue
  • Bloody stools, mucous
  • Cramps, constipation
  • Nocturnal diarrhea
  • Feeling poorly overall, w/spectrum of symptoms from mild to severe
  • Extra-GI: oral ulcers, joint pain/swelling, skin findings, low back pain, eye pain/vision problems, hepato-biliary sx (primary sclerosing cholangitis)
  • DVT: risk markedly increased w/IBD flair, immobility and/or hospitalization

Physical Exam Findings

  • Abdominal pain on palpation
  • Blood w/stool on rectal
  • Distention and severe illness if toxic megacolon
  • Extra-Colonic: aphtous ulcers, erythema nodosum, pyoderma gangrenosa, peripheral arthritis, ankylosing spondylitis/sacroiliitis, jaundice/RUQ pain, eye sx→ episcleritis/scleritis/uveitis

Links