Summary

  • Form of inflammatory bowel disease that affects the rectum and extends proximally. Characterized by diffuse inflammation of the colonic mucosa and a relapsing, remitting course.
  • Patients commonly experience bloody diarrhea, chronic diarrhea (or both), lower abdominal pain, fecal urgency, and extraintestinal manifestations, particularly those related to activity of the colitis.
  • Diagnosis requires endoscopy with biopsy and negative stool culture.
  • Relapses are often associated with pathogens; therefore, stool should be obtained for culture in all cases of disease flare-up.
  • Treatment aims to induce and maintain remission. Drug choice and formulation depends on the severity and extent of disease.
  • Toxic megacolon can occur with associated risk of perforation. Bowel adenocarcinoma is a complication in 3% to 5% of patients.

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