التهاب القولون التقرحي

Definition

Ulcerative colitis is chronic inflammation of the colonic mucosa, continuous from the rectum upward.

Symptoms

• Bloody diarrhoea with mucus
• Urgency and lower abdominal pain
• Fatigue and weight loss in severe flares
• Extraintestinal features: arthritis, eye inflammation, skin and liver disease

Diagnosis

Colonoscopy with biopsy, inflammatory markers and excluding infection.

Treatment

• Aminosalicylates (mesalazine) for mild–moderate flares and maintenance
• Steroids for flares, not long term
• Immunomodulators and biologics for moderate–severe disease
• Colectomy is curative for refractory disease

Complications

Toxic megacolon, haemorrhage, perforation and increased colorectal cancer risk with long-standing disease.

Nursing care

• Monitor stool frequency, blood, fluids and electrolytes
• Low-fibre diet during flares
• Surveillance colonoscopy for cancer

Exam point

A sudden fall in stool frequency with distension, fever and tachycardia during a severe flare may be toxic megacolon.