Ulcerative colitis

• Facts:
  Type of inflammatory bowel disease, limited to the colon
  Always involves the rectum
• History / PE:
  Abdominal pain, tenesmus
  Bloody diarrhea , anemia
  
  
• Diagnosis:
  Pseudopolyps
  Mucosal inflammation
  p-ANCA positive
• Treatment:
  1) Immunosuppressive agents (6-MP, azathioprine, MTX)
  2) 5-ASA derivatives (mesalamine, sulfasalzine)
  3) Steroids (excaerbations)
  4) Antibiotics (Flagyl for anal disease)
  5) Infliximab (TNF alpha antibody)
• Complications:
  Toxic megacolon (get abdominal xray)
  Primary sclerosing cholangitis
  Colorectal carcinoma
• Associated With:
  Ankylosing spondylitis (both HLA-B27 and + p-ANCA)
  Primary sclerosing cholangitis
  Erythema nodosum
  Pyoderma gangrenosum
  Episcleritis
  Arthritis
• Differential Diagnosis:
  Crohn's disease