Ulcerative Colitis (UC)

by Carlo Raj, MD

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    00:01 Let us now move on to ulcerative colitis.

    00:03 Ulcerative colitis will always begin in the rectum.

    00:07 It only involves the colon, may have what's known as backwash ileitis.

    00:13 Ulcerative colitis signs and symptoms here because it begins in the rectum and as the name implies will be ulcerated so it´s nasty, it´s exudated with bloody diarrhea.

    00:24 It´s exudative and tenesmus is often present.

    00:28 Symptoms must be present for at least a month and therefore making ulcerative colitis a diagnosis of exclusion. With ulcerative colitis it is a continuous type of lesion.

    00:44 So therefore you begin in the rectum, I need you to move proximally.

    00:49 Where are you going next? You´re going up the descending colon, you´re going through the transverse colon and you might be going then down the ascending, are we clear? The proximal continuous growth, no skip lesions are seen in ulcerative colitis.

    01:05 In ulcerative colitis the involvement is not transmural, it is superficial.

    01:13 Management here: Well, it´s inflammatory bowel disease.

    01:21 We have once again steroids, aminosalycilates, same concept.

    01:27 Immunomodulators (azathioprine, cyclosporin, tacrolimus, anti-TNF), anti-integrin therapy, anti-interleukin -12, -23 therapy.

    01:38 Surgical treatment: Colectomy is curative.

    01:42 Complication ulcerative colitis: because of the extensive damage that´s taking place with ulceration, and the continuous nature of it all, makes it much more prone to colorectal cancer.

    01:56 Here what we see is that there is continuous growth.

    02:02 There is no string sign and that part of the colon that has been affected, every portion of it in fact has, it is continuous, it is proximal growth.

    02:13 It begins in the rectum and pretty much only involves the colon.

    02:16 Completely different in that behavior when compared to Crohn´s disease.

    About the Lecture

    The lecture Ulcerative Colitis (UC) by Carlo Raj, MD is from the course Small and Large Intestine Diseases: Basic Principles with Carlo Raj.

    Included Quiz Questions

    1. Colon
    2. Small bowel
    3. Colon, cecum, and ileum
    4. Colon, cecum, ileum, and jejunum
    5. Colon, cecum, ileum, jejunum, and duodenum
    1. Backwash ileitis can occasionally occur in ulcerative colitis.
    2. Fistulas and fissures are common in ulcerative colitis.
    3. Noncaseating granulomas are commonly seen in ulcerative colitis.
    4. A patient with ulcerative colitis usually presents with thin, pencil-shaped stools.
    5. There is less risk of colon cancer in ulcerative colitis than in other conditions.

    Author of lecture Ulcerative Colitis (UC)

     Carlo Raj, MD

    Carlo Raj, MD

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    Excellent !!!
    By Sandrine D. on 27. May 2020 for Ulcerative Colitis (UC)

    He is an excellent teacher that help me understand the concept very well

    Need to expand on complications
    By Hamed S. on 09. March 2017 for Ulcerative Colitis (UC)

    For example no mention of primary scelorising cholangitis, need for colonscopy after 8 yrs of active disease and subsequent colectomy if premalignant lesions identified. Also no mention of toxic megacolon. It would have been good to discuss the hierarchy of management in these patients