|
Ulcerative colitis (UC) is an inflammatory chronic disease primarily affecting the colonic mucosa; the extent and severity of colon involvement are variable. In its most limited form it may be restricted to the distal rectum, while in its most extended form the entire colon is involved. UC belongs to the inflammatory bowel diseases (IBD), which is a general term for a group of chronic inflammatory disorders of unknown etiology involving the gastrointestinal tract. UC is usually associated with recurrent attacks with complete remission of symptoms in the interim. In Western Europe and in the USA, UC has an incidence of approximately 6 to 8 cases per 100.000 populations and an estimated prevalence of approximately 70 to 150 per 100.000 populations. The leading initial symptom of UC is diarrhea with blood and mucus, sometimes with pain. Fever and weight loss are less frequent. Extra intestinal symptoms can be an initial manifestation or can occur later in the course of the disease. Eighty percent of the patients have only proctitis or proctosigmoiditis, and only 20% have extensive colitis. However, in about 50% of patients with initial proctosigmoiditis, proximal extension occurs later, and in some patients the opposite takes place. Depending of the stage of the disease, endoscopy reveals reddening of the mucosa, increased vulnerability, mucosal bleeding, irregular ulcers, pseudopolyps, granularity, and loss of vascular architecture. Several drugs interacting with various points along the immune and inflammatory cascades are currently available for the treatment of UC. Corticosteroids, aminosalicylates, immunomodulators are the mainstay of medical treatment. |