Description An inflammatory dis...
Description
An inflammatory disease of the colon (large intestine) characterized by ulceration and episodes of bloody diarrhea. The inflammation begins in the rectum and spreads upward. The ulcerated areas become inflamed and may form small abscesses in the lining of the large intestine. The symptoms can be confused with an infection of the colon. The symptoms are recurrent. It is most commonly seen in women between the ages 15 and 40. There is an increased incidence of colon cancer associated with ulcerative colitis.
Symptoms
Diarrhea, often with blood and mucous, crampy abdominal pain, fever, weight loss, rectal discomfort that leads to frequent visits to the bathroom.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be performed. The most common test to establish the diagnosis is colonoscopy. Blood work is done to look for anemia and markers of inflammation such as ESR and CRP. Abdominal CT scan be done to rule out complications of colitis.
Other Specific Tests: colonoscopy with biopsy, barium enema
Do I need this test?
Do not repeat colonoscopy for at least five years for patients who have one or two small (< 1 cm) adenomatous polyps, without high grade dysplasia, completely removed via a high-quality colonoscopy. The timing of a follow-up surveillance colonoscopy should be determined based on the results of a previous high-quality colonoscopy. Evidence based (published) guidelines provide recommendations that patients with one or two small tubular adenomas with low grade dysplasia have surveillance colonoscopy five to 10 years after initial polypectomy. "The precise timing within this interval should be based on other clinical factors (such as prior colonoscopy findings, family history, and the preferences of the patient and judgment of the physician)."
Specialists:
General Surgery, Gastroenterology, Internal Medicine, Pediatrics, Family Practice, Pediatric Gastroenterology, Colon and Rectal Surgery
Workup:
A history and physical exam will be performed. The most common test to establish the diagnosis is colonoscopy. Blood work is done to look for anemia and markers of inflammation such as ESR and CRP. Abdominal CT scan be done to rule out complications of colitis.
Other Specific Tests: colonoscopy with biopsy, barium enema
Do I need this test?
Do not repeat colonoscopy for at least five years for patients who have one or two small (< 1 cm) adenomatous polyps, without high grade dysplasia, completely removed via a high-quality colonoscopy. The timing of a follow-up surveillance colonoscopy should be determined based on the results of a previous high-quality colonoscopy. Evidence based (published) guidelines provide recommendations that patients with one or two small tubular adenomas with low grade dysplasia have surveillance colonoscopy five to 10 years after initial polypectomy. "The precise timing within this interval should be based on other clinical factors (such as prior colonoscopy findings, family history, and the preferences of the patient and judgment of the physician)."
Specialists:
General Surgery, Gastroenterology, Internal Medicine, Pediatrics, Family Practice, Pediatric Gastroenterology, Colon and Rectal Surgery
Treatment
The goal of therapy is to calm inflammation, which will help relieve symptoms, decrease attacks and allow the colon to heal. Treatment may include: hospitalization, corticosteroids, 5-aminosalicylates such as mesalamine (Asacol), immunomodulators (azathioprine/Imuran, 6-mercaptopurine/6-MP, and infliximab/Remicade or other biologic agent). Surgery to remove the entire colon (total colectomy) may be necessary if the disease cannot be controlled with medication. This will cure the disease and remove the risk of colon cancer.