Surgery Definition – What is Ulcerative Colitis?
Surgery Definition – What is Ulcerative Colitis?
Ulcerative colitis is an inflammation of the large bowel or enteritis of the large bowel with sparing of the anal region.
Ulcerative colitis is bimodal in distribution and common in 20 -35 years of age and 50 -65 years of age. Ulcerative colitis is common in male and female. Ulcerative colitis is associated with autoimmune disorders. Pathologically, ulcerative colitis may involve submucosal and mucosal layers with dysplasia and metaplasia. There will be granular flat mucosa with shallow ulcers and crypt abscesses. Pseudopolyps may present on the recutm and colon. Backwash ileitis may occur ocassionally. Toxic megacolon is associated with ulcerative colitis.
Symptoms and signs of ulcerative colitis may include weight loss, anorexia and malaise. Patient may suffer from urgent defecation due to colitis which is bloody and fill with mucus. Constipation is also common especially in proctitis. Massive dilation of the colon and sepsis are related with toxic megacolon. Toxic megacolon is dilation of the colon for more than 6 cm on the plain film. High risk of cancer.
The investigation of ulcerative colitis may include full blood count which may reveal low hemoglobin count (anemia) , increase in white blood count, raise ESR and CRP. Barium studies may reveal spread of pseudopolyps affecting the rectum which spread proximally. Uniform horsepipe colon is common due to reduction in haustrae. Endoscopy is considered to assess the extent of the disease and for biopsies to be taken. Culture of the stool is required to rule out infective colitis.
The medical / conservative treatment of ulcerative colitis may include, anti inflammatories
such as oral 5 aminosalicylic acid such as sulphasalazine and mesalazine, steroids such as prednisolone and antibiotic such as metronidazole.for any complications that may develop.
Surgery is curative and consider if there is any failure of the medical management in patient with high risk of malignancy or patient with severe toxic megacolon and hemorrhage. Radical surgery is considered with removal of the diseased segment. Subtotal colectomy and ileostomy are considered in emergency situation. Elective panproctocolectomy is performed in cases where the entire bowel is affected by ulcerative colitis or any premalignant condition.
Ulcerative colitis is an inflammation of the large bowel or enteritis of the large bowel with sparing of the anal region.
Ulcerative colitis is bimodal in distribution and common in 20 -35 years of age and 50 -65 years of age. Ulcerative colitis is common in male and female. Ulcerative colitis is associated with autoimmune disorders. Pathologically, ulcerative colitis may involve submucosal and mucosal layers with dysplasia and metaplasia. There will be granular flat mucosa with shallow ulcers and crypt abscesses. Pseudopolyps may present on the recutm and colon. Backwash ileitis may occur ocassionally. Toxic megacolon is associated with ulcerative colitis.
Symptoms and signs of ulcerative colitis may include weight loss, anorexia and malaise. Patient may suffer from urgent defecation due to colitis which is bloody and fill with mucus. Constipation is also common especially in proctitis. Massive dilation of the colon and sepsis are related with toxic megacolon. Toxic megacolon is dilation of the colon for more than 6 cm on the plain film. High risk of cancer.
The investigation of ulcerative colitis may include full blood count which may reveal low hemoglobin count (anemia) , increase in white blood count, raise ESR and CRP. Barium studies may reveal spread of pseudopolyps affecting the rectum which spread proximally. Uniform horsepipe colon is common due to reduction in haustrae. Endoscopy is considered to assess the extent of the disease and for biopsies to be taken. Culture of the stool is required to rule out infective colitis.
The medical / conservative treatment of ulcerative colitis may include, anti inflammatories
such as oral 5 aminosalicylic acid such as sulphasalazine and mesalazine, steroids such as prednisolone and antibiotic such as metronidazole.for any complications that may develop.
Surgery is curative and consider if there is any failure of the medical management in patient with high risk of malignancy or patient with severe toxic megacolon and hemorrhage. Radical surgery is considered with removal of the diseased segment. Subtotal colectomy and ileostomy are considered in emergency situation. Elective panproctocolectomy is performed in cases where the entire bowel is affected by ulcerative colitis or any premalignant condition.