Lecture on Ulcerative Colitis

Overview of Inflammatory Bowel Disease (IBD)

• IBD causes inflammation in the small and large intestine.
• Specific types include Ulcerative Colitis and Crohn's Disease.

Ulcerative Colitis

• Inflammation and ulcers in the mucosa and submucosa of the large intestine (colon and rectum).
• Tissue erosion leads to open sores or ulcers.
• Flare-ups and remissions are common.
• Most common type of IBD.

Causes

• Initially thought to be due to environmental factors (diet, stress).
• Now considered autoimmune in origin.
• Cytotoxic T cells found in the epithelium of the colon.
• Potential cross-reactivity with gut bacteria.
• Genetic predisposition and certain demographics (young women, caucasians, eastern European Jews) are more prone.

Pathophysiology

• Continuous and circumferential pattern of ulceration starts from the rectum.
• Inflammation without breaks of normal tissue.
• Pain in the left lower quadrant.
• Diarrhea and blood in stool due to mucosal destruction and impaired water absorption.

Diagnosis

• Colonoscopy: Camera inserted through the anus to view and biopsy ulcers.
• Radiological Imaging: CT scan, MRI, barium enema.

Treatment Options

• Medications:
  • Anti-inflammatory drugs (sulfasalazine, mesalamine).
  • Immunosuppressants (corticosteroids, azathioprine, cyclosporine).
  • Biologics (infliximab, adalimumab, golimumab).
• Surgical:
  • Colectomy (removal of the colon) for severe cases.

Summary

• Ulcerative colitis: most common type of IBD with ulcers in colon and rectum.
• Diagnosed via colonoscopy and barium enema.
• Treated with anti-inflammatory meds, immunosuppressants, or colectomy in severe cases.