Ulcerative Colitis Questions & Answers

Updated: Jul 26, 2019
  • Author: Marc D Basson, MD, PhD, MBA, FACS; Chief Editor: BS Anand, MD  more...
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Questions & Answers

Overview

What is ulcerative colitis (UC)?

What are the symptoms of ulcerative colitis (UC)?

What are the signs and symptoms of fulminant ulcerative colitis (UC)?

Which extracolonic conditions are associated with ulcerative colitis (UC)?

What are the physical findings in severe ulcerative colitis (UC)?

How is the severity of ulcerative colitis (UC) graded?

Which laboratory studies are used in the diagnosis of ulcerative colitis (UC)?

Which procedure is most commonly used in the diagnosis of ulcerative colitis (UC), and what are the characteristic findings?

How is ulcerative colitis (UC) defined based on the extent of disease?

Which imaging studies are useful in the diagnosis of ulcerative colitis (UC)?

What treatment options are available for the medical management of mild ulcerative colitis (UC) and acute severe UC?

When is surgery indicated in a patient with ulcerative colitis (UC)?

What surgical options are available to patients with ulcerative colitis (UC)?

Which segment of the bowel is most commonly affected by ulcerative colitis (UC)?

What is the etiology of ulcerative colitis (UC)?

What are the pathologic features of ulcerative colitis (UC)?

What is the initial treatment for patients with ulcerative colitis (UC)?

Which segments of the digestive tract are involved in ulcerative colitis (UC)?

What types of immunologic changes are associated with ulcerative colitis (UC)?

Which antibodies have been associated with ulcerative colitis (UC)?

Which microscopic findings are characteristic of ulcerative colitis (UC)?

What etiologic factors are associated with ulcerative colitis (UC)?

What is the relationship between a patient’s smoking history and the need for surgical intervention in ulcerative colitis (UC)?

What is the role of genetics in the development of ulcerative colitis (UC)?

Which antibodies are associated with ulcerative colitis (UC)?

What is the relationship between appendectomy and ulcerative colitis (UC)?

What bacterial factors are associated with the development of ulcerative colitis (UC)?

What is the role of NSAIDs in the development of ulcerative colitis (UC)?

What are some of the less common factors associated with ulcerative colitis (UC)?

What are the prevalence and incidence rates of ulcerative colitis (UC) in the US?

Is there a racial predilection in ulcerative colitis (UC) in the US?

Is ulcerative colitis (UC) more common in men or women?

At what age does ulcerative colitis (UC) most commonly develop?

Is there a geographic predilection in ulcerative colitis (UC)?

Does ulcerative colitis (UC) increase the risk of mortality?

Which comorbidities are associated with ulcerative colitis (UC)?

What potentially fatal complications are associated with ulcerative colitis (UC)?

Presentation

What signs and symptoms are associated with insidious onset of ulcerative colitis?

What signs and symptoms are associated with fulminant onset of ulcerative colitis?

Which extracolonic manifestations are associated with ulcerative colitis (UC)?

What is the role of primary sclerosing cholangitis (PSC) in ulcerative colitis (UC)?

Which comorbidities have been reported but are not commonly associated with ulcerative colitis (UC)?

What are the typical physical findings in patients with ulcerative colitis (UC)?

How is the severity of ulcerative colitis (UC) graded?

DDX

Which conditions should be considered in the differential diagnosis of ulcerative colitis (UC)?

How is ulcerative colitis (UC) differentiated from Crohn disease, and why is the distinction important?

According to guidelines, which conditions, in addition to Crohn disease, should be excluded in the differential diagnosis of ulcerative colitis (UC)?

What are the differential diagnoses for Ulcerative Colitis?

Workup

Which procedure should be performed for a definitive diagnosis of ulcerative colitis (UC)?

What is the role of laboratory studies in the diagnosis of ulcerative colitis (UC)?

What is the role of radiographic imaging in the diagnosis of ulcerative colitis (UC)?

Why is a double-contrast barium enema exam important in the diagnosis of ulcerative colitis (UC)?

What is the role of colon biopsy in the diagnosis of ulcerative colitis (UC)?

What is the role of other radiologic studies in the diagnosis of ulcerative colitis (UC)?

Which antibodies are the focus of most ulcerative colitis (UC) research?

Which antibodies are most commonly associated with ulcerative colitis (UC)?

What CBC count findings are associated with ulcerative colitis (UC)?

Which comprehensive metabolic panel findings are associated with ulcerative colitis (UC)?

Which inflammatory markers suggest ulcerative colitis (UC)?

What is the role of stool studies in the diagnosis of ulcerative colitis (UC)?

Should endoscopy or sigmoidoscopy be performed prior to colonoscopy when ulcerative colitis (UC) is suspected?

Which types of mucosa should be sampled during biopsy when ulcerative colitis (UC) is suspected?

How is a diagnosis of ulcerative colitis (UC) confirmed?

How is the extent of disease defined in ulcerative colitis (UC)?

What histopathologic findings are consistent with ulcerative colitis (UC)?

What is the role of imaging in the diagnosis of ulcerative colitis (UC), and which studies are useful?

Treatment

What is the standard medical treatment for ulcerative colitis (UC), and what are the surgical options, when indicated?

What is the association between colon cancer and ulcerative colitis (UC)?

Is regular endoscopic cancer screening indicated in patients with ulcerative colitis (UC)?

What consultations are recommended for patients with ulcerative colitis (UC)?

How is mild ulcerative colitis (UC) treated?

What are the recommendations for long-term maintenance therapy after remission in mild ulcerative colitis (UC)?

What is the role of systemic steroid therapy in the treatment of mild-to-moderate ulcerative colitis (UC)?

How is acute, severe ulcerative colitis (UC) treated?

What is the role of infliximab in the treatment of acute, severe ulcerative colitis (UC)?

What is the role of monoclonal antibody drugs in the treatment of ulcerative colitis (UC)?

How is vedolizumab used in the treatment of acute, severe ulcerative colitis (UC)?

What nonstandard therapies are available for the treatment of acute, severe ulcerative colitis (UC)?

When is surgery indicated in patients with ulcerative colitis (UC), and what are the indications for urgent surgery?

Does research support ileal pouch-anal anastomosis for the treatment of ulcerative colitis (UC)?

What is the role of maintenance therapy for ulcerative colitis (UC) in patients who are in remission?

What treatment options are available for maintenance therapy in ulcerative colitis (UC)?

Are dietary restrictions part of the maintenance therapy for ulcerative colitis (UC)?

What complications are associated with ileal pouch-anal anastomosis procedures in patients with ulcerative colitis (UC)?

What are the outcomes of ileal pouch-anal anastomosis in ulcerative colitis (UC)?

How is sexual function affected by ileal pouch-anal anastomosis in patients with ulcerative colitis (UC)?

What is pouchitis, how common is it, and how is it treated in patients with ileal pouch–anal anastomosis resulting from ulcerative colitis (UC)?

What is the incidence of toxic megacolon in patients with ulcerative colitis (UC), what are its causes, and how is it treated?

What is the risk of colorectal cancer in patients with ulcerative colitis (UC), and what are the guidelines for surveillance and treatment?

What are the long-term surveillance and treatment options for ulcerative colitis (UC)?

Guidelines

What are the guidelines on the treatment of ulcerative colitis?

Medications

What are the goals of pharmacotherapy in ulcerative colitis (UC)?

Which medications in the drug class 5-aminosalicylic Acid Derivative are used in the treatment of Ulcerative Colitis?

Which medications in the drug class Tumor Necrosis Factor Inhibitors are used in the treatment of Ulcerative Colitis?

Which medications in the drug class Immunosuppressant Agents are used in the treatment of Ulcerative Colitis?

Which medications in the drug class Corticosteroids are used in the treatment of Ulcerative Colitis?

Which medications in the drug class Alpha 4 Integrin Inhibitors are used in the treatment of Ulcerative Colitis?

Which medications in the drug class JAK Inhibitors are used in the treatment of Ulcerative Colitis?

Which medications in the drug class Antimicrobials are used in the treatment of Ulcerative Colitis?

Which medications in the drug class Antidiarrheal are used in the treatment of Ulcerative Colitis?