Course of disease
On average, Ulcerative colitis presents between the age of 20 and 30. However, infants as well as elderly people can present with Ulcerative colitis. Recent reports have shown that Ulcerative colitis has become an uncommon entity among adolescent children. In Ulcerative colitis the intestinal inflammation is restricted to the colon, in contrast to Crohn's disease, which can involve any part of the gastrointestinal tract. Ulcerative colitis is often subdivided into three categories based on the extension of colon inflammation: proctitis, in which only the rectum is inflamed, proctosigmoiditis, in which the inflammation extends approximately 35 cm from the anus, and total colitis, in which the entire colon is involved. In approximately 30% of cases, a larger part of the colon will become inflamed over a period of time. Because of the risk of developing cancer in cases of longstanding total colitis, these patients are generally included in surveillance programmes. Most recent reports however suggest this increased risk to be very low.
Symptoms
Diarrhoea with rectal bleeding is typical for Ulcerative colitis, often in combination with mild to moderate abdominal pain. Except in the most severe cases, weight loss is a rather uncommon symptom.
Non-gastrointestinal Ulcerative colitis
Approximately 10% of Ulcerative colitis patients have disease manifestation outside the gastrointestinal tract. Joint pain and inflammation are the most common non-gastrointestinal manifestations. More rarely the skin, eyes or liver may be involved.
Investigation
Diagnosis of Ulcerative colitis is based on a typical medical history in combination with endoscopical or radiological examination. Blood samples may typically reveal signs of ongoing inflammation. Stool specimens may be needed in order to exclude an infectious origin.