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This disease typically begins in the sigmoid colon and/or rectum, and then usually progresses until the entire colon is affected.
Incidence It is seen in both sexes equally, although white and Jewish people are more often affected. A person is five times more likely to get it if one parent has the condition. Peak occurrence is from 15-35 years of age, although any age is susceptible. Ulcerative colitis may also cause problems such as arthritis, inflammation of the eye, liver disease (fatty liver, hepatitis, cirrhosis, and primary sclerosing cholangitis), osteoporosis, skin rashes, anemia, and kidney stones. No one knows for sure why problems occur outside the colon. Systemic and extracolonic symptoms include: skin changes; liver disease; posterior uveitis, etc.; decreased growth and development; and failure to thrive (in children).
Diagnosis & Tests In order to confirm the diagnosis, testing may include barium X-rays of the upper and lower GI tract, flexible sigmoidoscopy, and sometimes colonoscopy. During these tests, biopsies may be obtained. Laboratory findings:- Definitive diagnosis requires a colonic mucosal biopsy
- Normocytic anaemia (acute blood loss) or microcytic anaemia (iron deficiency due to chronic blood loss)
- Gross or occult blood in stool; WBC in stool
- Leukocytosis during acute exarcerbation
- Increased sedimentation rate - indicates active inflammation
- Decreased serum K, Na CI - due to diarrhoeal loss
- Decreased serum albumin due to loss of protein from the diseased bowel wall; the degree of hypoalbuminaemia parallels the severity of the disease
- Increased alkaline phosphatase, SGOT (AST) and bilirubin due to associated liver disease.
Treatment & Prevention If candida or a bacterial overgrowth is present, further recovery in ulcerative colitis can be achieved by correcting the imbalance through antimicrobial or antifungal agents.
Complications Carcinoma of the colon, gastrointestinal bleeding, arthritis. |
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