ulcerative colitis (ibd)

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  1. 1. Ulcerative Colitis
  2. 2. Agenda Revising the digestive system Understanding Inflammatory Bowel Disease (IBD) Learning about Ulcerative Colitis
  3. 3. Digestive system IBD affects the digestive system. Before we learn about the disease lets revise the parts of the digestive system
  4. 4. Large intestine One form of IBD, ulcerative colitis affects only the large intestine The parts of the large intestine are important to remember In order these are parts of the large intestine Ascending colon Transverse colon Descending colon Sigmoid colon Rectum
  5. 5. Inflammatory Bowel Disease(IBD) IBD refers to recurrent chronic diseases that cause inflammation of the intestines There are two main types of IBD Ulcerative colitis (UC) Crohns disease (CD) Normal Colon Inflamed Colon
  6. 6. Difference between CD and UC UC affects only the large intestine CD can affect any part of the gastrointestinal tract. But most frequently attacks terminal ileum and colon Approx. 15% of patients have signs that falls between UC and CD (indeterminate colitis)
  7. 7. Ulcerative colitis (UC) It is a type of IBD Affects only the large intestine Rectum is always involved in ulcerative colitis Always starts in rectum The inflammation is in a continuous stretch For instance if ulcerates colitis affects the descending colon, then there will be inflammation in the descending colon, sigmoid colon and rectum 7
  8. 8. Ulcerative colitis (UC) Out of the four layers in the wall of the large intestine, the inflammation involves the mucosa and submucosa The mucosa look ulcerated and granular With a severe attack, the mucosa becomes hemorrhagic (bleeds easily) & ulcerated 8
  9. 9. UC can be divided into 5 types based on the how of the large intestine is affected Proctitis Proctosigmoiditis Distal colitis Extensive colitis Pancolitis
  10. 10. Distribution of the subtypes of UC in India In patients with UC have Pancolitis (entire colon) 42.8% Left sided colitis 38.8 % Proctitis alone in 18.3 % 10
  11. 11. What is the cause of UC? (Pathophysiology) UC is an autoimmune disease Meaning that the immune system is attacking the body The exact cause is not yet known It is known that three factors interact to cause UC They include the immune system, certain genes and some environmental factors 11
  12. 12. What are the symptoms of UC? Bloody diarrhea with or without mucus is the hallmark of ulcerative colitis Diarrhea Rectal bleeding Tenesmus Passage of mucus Abdominal pain
  13. 13. How is ulcerative colitis diagnosed? Ulcerative colitis cannot be diagnosed by a single tests The diagnosis of UC involves the following History of the patient Physical examination Laboratory tests Endoscopy Tissue biopsy Based on the findings of all these investigations a diagnosis of UC can be made
  14. 14. How is ulcerative colitis classified based on severity? Ulcerative colitis can be classified on the basis of how severe the symptoms are Based on this the severity is as follows; Mild Moderate Severe Fulminant The severity of UC is determined by certain clinical scores
  15. 15. Clinical Score to Determine Severity >30>30< 30ESR Transfusion required90>90NormalPulse >37.5> 37.5NormalTemperature (C) ContinuousFrequentIntermittentBlood in Stool >10>6 -

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