Ulcerative colitis is a diffuse inflammatory disease of the co | Surgery videos & books

Ulcerative colitis is a diffuse inflammatory disease of the colon and rectum with unknown etiology. Unlike Crohn’s disease, surgical removal of the entire colon and rectum provides a complete cure. Nonetheless, many patients are treated successfully with medical therapy including corticosteroids and can avoid the potential complications of surgery and lifelong ileostomy. Ulcerative colitis usually presents as bloody diarrhea, fever, and abdominal pain. The disease process begins in the rectum, advances proximally in a contiguous fashion, and affects the superficial layers of the colon wall. Crohn’s disease is located anywhere from the mouth to anus, has skip lesions, and is transmural in nature. Histologically, superficial inflammation with crypt abscesses is most indicative of ulcerative colitis, whereas deeper involvement with granulomas and fissures are most characteristic of Crohn’s disease. Both diseases may present with extraintestinal manifestations such as arthritis, skin lesions, and hepatic dysfunction, but perianal disease with fistula formation is characteristic of Crohn’s disease. Patients with ulcerative colitis have a 10–20% risk of developing colon cancer within 20 years after diagnosis. The incidence is also increased in those with Crohn’s disease but to a lesser extent. Surveillance colonoscopy is essential in patients with long-standing disease.