Let us now move on to ulcerative colitis.
Ulcerative colitis will always begin in the rectum.
It only involves the colon, may have what's known as backwash ileitis.
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.
It´s exudative and tenesmus is often present.
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.
So therefore you begin in the rectum, I need you to move proximally.
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.
In ulcerative colitis the involvement is not transmural, it is superficial.
Management here: Well, it´s inflammatory bowel disease.
We have once again steroids, aminosalycilates, same concept.
Immunomodulators (azathioprine, cyclosporin, tacrolimus, anti-TNF).
Surgical treatment: Colectomy is curative.
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.
Here what we see is that there is continuous growth.
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.
It begins in the rectum and pretty much only involves the colon.
Completely different in that behavior when compared to Crohn´s disease.