Ulcerative colitis
| Non-granulomatous relapsing and remitting continuous inflammation in colonic mucosa | |
|---|---|
| Etiology | Age of onset 15-30 years. |
| Epidemiology | |
| Clinical presentation | PR bleeding axial/peripheral arthritis, erythema nodosum, pyoderma gangrenosum, anal skin tags, fistulae (in any location), osteopenia, uveitis/episcleritis, anaemia. |
| Pathogenesis | |
| Diagnostic investigations | stool culture, faecal calprotectin Colonoscopy + biopsy: inflammatory infiltrate; ↓ goblet cells; mucosal ulcers; crypt abscesses; backwash ileitis |
| Management | See below |
inducing remission
mild to moderate first presentation
- first line: topical aminosalicylate
- second line: ADD oral aminosalicylate
- third line: topical/oral corticosteroid
acute severe
- first line: IV corticosteroid (ciclosporin possible as alternative)
- second line: ADD ciclosporin to IV corticosteroid
- infliximab if ciclosporin contraindicated
related topics
sources/links
Robbins; BMJ best practice
https://www.pathologyoutlines.com/topic/smallboweluc.html