Ulcerative colitis is an idiopathic inflammatory bowel disease of the colon or rectal mucosa. Frequent, bloody diarrhea is the characteristic feature of ulcerative colitis with unpredictable relapses occurring between periods of remission (1). Abdominal pain (not cramping) is an uncommon complaint due to the superficial nature of inflammation in ulcerative colitis (1).
Approximately 500,000 people in the U.S. population have ulcerative colitis with an additional 10-12 cases/100,000 people each year who are newly diagnosed (2, 3). The peak age of onset is between 15-30 years. Caucasians are affected more frequently with an equal incidence occurring in males and females (2-5).
Depending upon the severity and extent of the disease, other symptoms may include tenesmus, weight loss, and extraintestinal manifestations (arthropathies, erythema nodosum, ocular conditions, and cholestatic disease) (6, 7). The majority of patients present with proctitis or distal disease, followed by left-sided disease, or total colitis (1). Complications of ulcerative colitis such as toxic megacolon may require surgery (7). Surgery, in some cases, can also be curative (5).
Ulcerative colitis can cause significant morbidity and is a substantial economic burden to patients and their families. This inflammatory condition accounts for a quarter million physician visits and 20,000 hospitalizations each year (8). Compared with the general population, quality of life in patients with IBD is considerably impaired (6). Ulcerative colitis patients often have particular concerns about wearing an ostomy bag, developing cancer, the effects of medications, the uncertain nature of the disease, and having surgery (6). While in most case patients can expect lifelong exacerbations and remissions during the course of the disease, they can also expect to live a useful and productive life span with appropriate treatment (4).
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Treatment.htm. - Bashar Al-Ataie M, Shenoy VN. Ulcerative Colitis. Emedicine from WebMD. Available at: http://www.emedicine.com/med/topic2336.htm. Accessed June 23, 2006.
- About ulcerative colitis and proctitis. Crohn's & Colitis Foundation of America. Available at: http://www.ccfa.org/info/about/ucp. Accessed June 23, 2006.
- Ford D. Ulcerative Colitis. American Society of Colon and Rectal Surgeons. Available at: http://www.fascrs.org/displaycommon.cfm?an=1&subarticlenbr=314. Accessed June 23, 2006.
- Friedman S, Blumberg RS. Inflammatory Bowel Disease. In: Harrison's Internal Medicine. McGraw-Hill Access Medicine. 2006. The McGraw-Hill Companies. Available at: http://www.accessmedicine.com/content.aspx?aID=90323.
- Rowe WA. Inflammatory Bowel Disease. Emedicine from WebMD. Available at: http://www.emedicine.com/med/topic1169.htm. Accessed June 23, 2006. Last updated May 23, 2006.
- Kornbluth A, Sachar D. Ulcerative Colitis Practice Guidelines in Adults (Update). American Journal of Gastroenterology. 2004.