Ulcerative colitis
Ulcerative colitis is an inflammatory bowel disease affecting the rectum and a variable portion of the colon. There is inflammation and ulceration of the mucosa and submucosa similar to that seen in infection. It is often characterised by periods of relapse and remission. The symptoms depend on how much of the bowel is affected: if it is only the rectum then there may be constipation and blood stained stools; if it is the whole of the large bowel and the disease is very active there may be profuse bloody diarrhoea both day and night associated with abdominal pain, fever and weight loss. There is no known cause, but there is some evidence of a genetic susceptibility with an association with other diseases such as ankylosing spondylitis, in patients whose tissue type is HLA B27. In some patients attacks may be prevented by using certain anti-inflammatory agents, but exacerbations may require steroid treatment. In severe and refractory cases surgical intervention may be required.
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