Introduction
Ulcerative colitis is another inflammatory bowel disease, but contrary to Crohn’s disease ulcerative colitis is only confined to the large intestine and the rectum. Ulcerative colitis always leads to bloody diarrhea.
There are no perianal or other fistulas associated with it. There is no known cause for ulcerative colitis. The main pathological lesions are micro abscesses and ulcerations in the mucosa lining of the colon, which can occur from the rectum just inside the anal ring all the way up to the ileocecal valve.
Ulcerative colitis
These ulcerations develop in mucosa where prior damage had occurred with infiltration of the deeper layers of the mucosa with inflammatory cells and a closing of the sub-epithelial capillaries.
It is unknown why these changes occur, but without blood supply these ulcerations happen. This pathological process starts in the rectum and sigmoid colon area, which is the lower end of the large intestine. From there it has a tendency to progress slowly upwards into the descending (on the left abdomen), the transverse (crossing the top of the abdomen) to the ascending colon (located in the right abdomen). However, in a small percentage of patients with a more benign form of ulcerative colitis it stays confined to the rectum.
Symptoms of Ulcerative Colitis
The first sign might be some mild lower or left abdominal pain. This is followed by an urgency to defecate and the passing of blood and mucous in the stools. Eventually diarrhea with blood in it will develop. Occasionally a severe attack might develop with high fever, acute abdominal spasms, acute, bloody diarrhea, signs of peritonitis and a toxic appearance. The physician must sort out whether there is another overlying bacterial or parasitic colitis, whether this is only a bad bout of ulcerative colitis, or whether there is one of the complications listed below that is presenting itself. Several tests may have to be done to help the physician to diagnose the condition properly.
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