Ulcerative colitis (UC)
Ulcerative Colitis (UC) is a chronic inflammatory condition confined primarily to the colon and rectum, forming part of a group of conditions known as Inflammatory Bowel Diseases (IBD). It is characterized by the inflammation and continuous ulceration of the mucosal layer of the colon, which distinguishes it from Crohn's Disease, another type of IBD that can affect any part of the gastrointestinal tract and involves deeper layers of the bowel wall. The exact etiology of UC remains unclear, but it is understood to be a complex interplay of genetic predisposition, environmental factors, immune system malfunctions, and alterations in the gut microbiome.
Clinically, UC presents with symptoms including persistent diarrhea, rectal bleeding, abdominal pain, and urgency in bowel movements. The severity of these symptoms can range from mild to debilitating, often with periods of remission and exacerbation. Complications may include severe bleeding, perforated colon, and an increased risk of colon cancer, particularly in patients with extensive and long-standing inflammation.
Diagnostically, UC is confirmed through a combination of endoscopic examination of the colon, histopathological analysis of colonic biopsies, and imaging studies. Management strategies for UC aim at inducing and maintaining remission, and involve the use of medications such as aminosalicylates, corticosteroids, immunomodulators, and biologics targeting specific pathways of the immune system. In severe cases, surgical interventions such as colectomy may be necessary. Additionally, lifestyle modifications and nutritional support play a crucial role in managing symptoms and improving quality of life. Ongoing research continues to explore the pathogenesis of UC, seeking to develop more targeted and effective therapies and to understand the long-term impacts of the disease.
References:
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Gajendran M, Loganathan P, Jimenez G, Catinella AP, Ng N, Umapathy C, Ziade N, Hashash JG. A comprehensive review and update on ulcerative colitis. Dis Mon. 2019 Dec;65(12):100851. doi: 10.1016/j.disamonth.2019.02.004. Epub 2019 Mar 2. PMID: 30837080. [L]
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Gros B, Kaplan GG. Ulcerative Colitis in Adults: A Review. JAMA. 2023 Sep 12;330(10):951-965. doi: 10.1001/jama.2023.15389. PMID: 37698559. [L]
Lynch WD, Hsu R. Ulcerative Colitis. 2023 Jun 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 29083748. [L]
Conrad K, Roggenbuck D, Laass MW. Diagnosis and classification of ulcerative colitis. Autoimmun Rev. 2014 Apr-May;13(4-5):463-6. doi: 10.1016/j.autrev.2014.01.028. Epub 2014 Jan 11. PMID: 24424198. [L]
Rubin DT, Ananthakrishnan AN, Siegel CA, Sauer BG, Long MD. ACG Clinical Guideline: Ulcerative Colitis in Adults. Am J Gastroenterol. 2019 Mar;114(3):384-413. doi: 10.14309/ajg.0000000000000152. PMID: 30840605. [L]
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Biomarkers related to this condition:
ANCA Screen includes evaluation for p-ANCA, c-ANCA and atypical p-ANCA. A positive ANCA screen reflexes to titer and pattern(s), e.g., cytoplasmic pattern (c-ANCA), perinuclear pattern (p-ANCA), or atypical p-ANCA pattern. c-ANCA and p-ANCA are obser
Learn moreAtypical perinuclear antineutrophil cytoplasmic antibodies (p-ANCA) occur in most patients with ulcerative colitis but only in a minority of those with Crohn's disease.
Learn moreStreptococcus salivarius
Higher abundance of S. salivarius and S. thermophilus (Firmicutes phylum) have been associated with a moderate to severe disease course in newly diagnosed ulcerative colitis (UC) patients. These findings are in accordance with a study that showed
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