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Results for “Colitis, Ulcerative”

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PubMed2002

Proctitis with caecitis: an atypical presentation of ulcerative colitis.

Ulcerative colitis is characterized as an inflammatory process of the distal colonic mucosa, which may extend proximally. Its proximal extension is classically as a continuous lesion. We describe six patients presenting with typical ulcerative proctiits, who were also found to have an inflammatory area in the caecum, while the remaining colon was macroscopically and histologically normal. With no features to support a diagnosis of Crohn's disease, we believe these cases challenge the classic teaching that ulcerative colitis is a continuous disease. Performing total colonoscopy in patients who seem to have solely distal colitis will permit recognition of this distribution of inflammation.

Adult↗

PubMed1994

Histochemical and metabolic changes in functioning ileal pouches after proctocolectomy for familial adenomatous polyposis and ulcerative colitis.

Ulcerative colitis and familial adenomatous polyposis may be treated by proctocolectomy with ileal pouch reconstruction, anastomosing the pouch to the anus. We studied 24 patients who underwent this procedure, of whom 12 had ulcerative colitis and 12 had familial adenomatous polyposis. Ileal absorption was investigated and pouch histology assessed more than one year after closure of the protective defunctioning loop ileostomy. The results showed a reduction in bile acid reabsorption and vitamin B12 absorption. These observations were associated with a morphologic transformation in the small bowel mucosa to large bowel mucosa. In 10 of the 12 colitis patients one or more of the histological features of the original disease (such as active inflammation, increased regeneration, atypia) were evident. Histological examination of the biopsies taken from the polyposis patients showed areas with an excess of sialomucins.

Absorption↗

PubMed1981

Scleromalacia perforans in ulcerative colitis.

Ulcerative colitis is associated with many ocular complications. The only systemic disease currently recognized to be complicated by scleromalacia perforans is rheumatoid arthritis. A 36-yr-old male is described whose long-standing ulcerative colitis was complicated by scleromalacia perforans at a time of disease activity. The scleromalacia was successfully treated with high-dose steroids and total proctocolectomy.

Adult↗

PubMed1996

Lymphocytic encephalomyeloneuritis as a neurologic complication of ulcerative colitis.

Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease (IBD) showing immunologic abnormalities and association with autoimmune states (Snook et al., 1989). Extraintestinal manifestation of UC affect various organ systems (Podolsky, 1991). We describe morphologically documented encephalomyeloneuritis in a 58-year-old white male with UC in full remission providing support for the concept that ulcerative colitis may be complicated by neurologic manifestations affecting both the central and peripheral nervous system.

Colitis, Ulcerative↗

PubMed1997

Effects of Boswellia serrata gum resin in patients with ulcerative colitis.

Ulcerative colitis is a chronic inflammatory disease of the colon where leukotrienes are suggested to play an important role for keeping inflammation active. Boswellic acids, the biologically active ingredients of the gum resin of Boswellia serrata (Sallai guggal), have been shown to be specific, nonredox and noncompetitive inhibitors of 5-lipoxygenase, the key enzyme of leukotriene biosynthesis. In patients suffering from ulcerative colitis grade II and III the effect of Boswellia serrata gum resin preparation (350 mg thrice daily for 6 weeks) on stool properties, histolopathology and scan microscopy of rectal biopsies, blood parameters including Hb, serum iron, calcium, phosphorus, proteins, total leukocytes and eosinophils was studied. Patients receiving sulfasalazine (1 g thrice daily) served as controls. All parameters tested improved after treatment with Boswellia serrata gum resin, the results being similar compared to controls: 82% out of treated patients went into remission; in case of sulfasalazine remission rate was 75%.

Abdominal Pain↗

PubMed1997

[Non-surgical therapy for ulcerative colitis].

Ulcerative colitis involving primarily the mucosa of the colon and rectum is a diffuse and nonspecific inflammatory disease. Immunocompetent cells infiltrating in the inflammed mucosa are mainly lymphocytes, macrophages and neutrophils. These activated cells produce proinflammatory cytokines such as IL-1, IL-6, IL-8 and TNF alpha and inflammatory activators such as PAF, leukotriene, prostaglandins, free radicals and proteases, resulting in acute on chronic states. Non-surgical therapy for ulcerative colitis includes basic medical therapy with sulfasulphapyridine, 5-ASA, corticosteroids and immune suppressive drugs as well as new therapies, which are leukocytapheresis, granulocytapheresis, anticytokine therapy with antiTNF alpha monoclonal antibody, IL-1ra and IL-10, intravenous treatment of massive immunoglobulins and transdermal nicotine therapy.

Colitis, Ulcerative↗

PubMed1975

Sequelae of colectomy and ileostomy: comparison between Crohn's colitis and ulcerative colitis.

A comparison is made of the immediate and long term mortality of colectomy and ileostomy between 73 patients who had Crohn's colitis and 442 who had ulcerative colitis. The immediate mortality in Crohn's disease is 4%. In ulcerative colitis it is 10%, chiefly because of the higher proportion of emergency operations. The late mortality in both groups is 10%, chiefly as a result of recurrence of Crohn's disease or the sequellae of colonic malignancy present at the time of colectomy for ulcerative colitis. A further comparison is made between the postoperative course of the 64 surviving patients with Crohn's disease and a comparable sample of 65 patients who had an ileostomy for ulcerative colitis in the same era. There was a similar incidence of postoperative septic complications in the two groups (35%). The readmission rate was twice as high in the Crohn's disease patients. Ileostomy reconstruction for mechanical complication was needed in 21 patients with Crohn's disease compared with 6 with ulcerative colitis. Further ileal resection was required for recurrent disease on another 25 occasions in the patients with Crohn's disease but never in those with ulcerative colitis. Long therm review graded the clinical status as excellent or good in 70% of those with Crohn's disease compared with 95% with ulcerative colitis.

Adult↗

PubMed1989

Surgical treatment of chronic ulcerative colitis.

Ulcerative colitis requiring surgical removal of the colon can be approached via four surgical options: previously (until 1975) by a Brooke ileostomy or ileorectostomy, and more recently by a Kock's continent reservoir ileostomy and ileal pouch-anal anastomosis. This review assesses the current surgical alternatives with particular emphasis on ileal-pouch anastomosis. Ileal pouch-anal anastomosis is described in detail, since this is the preferred method at the Mayo Clinic in patients in whom proctocolectomy is recommended. 390 patients operated on for chronic ulcerative colitis by this method were followed up for at least 6 months postoperatively. Ninety-four percent of the patients were ultimately satisfied with their results despite a few postoperative complications. Twenty-four patients had their ileal pouch-anal anastomosis taken down and either a Brooke ileostomy or a continent ileostomy established because of pelvic sepsis or subsequent appearance of Crohn's disease or poor functional results. In some cases a Kock pouch was fashioned. When all is said and done, ileal pouch-anal anastomosis is the only procedure that promises to meet the criteria for an ideal operation. If appropriately timed and done by experienced surgeons, the beneficial effect of such a curative, yet continence-preserving procedure could be profound.

Anal Canal↗

PubMed1985

[Timing of surgical intervention in ulcerative colitis].

Ulcerative colitis is a borderline disease between medicine and surgery and ultimate evaluation of medical or surgical therapy remains to be settled. Except for the absolute indication for operation (toxic dilatation, perforation, bleeding and etc.), it is not always easy to consider surgery for this disease because so many factors influence its clinical course. Nevertheless, a prudent decision regarding surgery seems mandatory for a reasonable surgical therapy with a low mortality and high curability that enables an earlier rehabilitation and more complete social activity. The total number of primary operative cases of ulcerative colitis in our clinic over a period of March 1954 through the end of December 1983 was 30. A comparison of our experience up to the end of 1965 and since then has shown an operative mortality of 2/14 in the first and 1/16 in the second period, and that all these 3 deaths were through an emergency operation but not through 29 cases of elective surgery. It is emphasized that one of the most important factors influencing outcome of operation is whether or not it is undertaken as an urgent surgery during a hard time of the disease that has failed to respond to intensive medical treatment.

Adult↗

PubMed1992

Therapeutic advances in ulcerative colitis.

Ulcerative colitis is an inflammatory condition that requires individualized and innovative therapy for each patient depending on the symptoms, location, severity, and chronicity of the disease. It is most often a chronic illness that requires modification in treatment as the stage of the disease changes. Systemic and rectal aminosalicylates (sulfasalazine, mesalamine, olsalazine and corticosteroids) remain the most useful therapeutic agents. Rectally administered mesalamine and the forms of oral mesalamine appear to have significant advantage over sulfasalazine dosage forms. Future clinical usage and scientific study will determine the place of these newer agents among other medical therapies and the surgical management of ulcerative colitis.

Colitis, Ulcerative↗

PubMed2003

[Management of ulcerative colitis].

Ulcerative colitis is a chronic inflammatory bowel disease. The disease is diagnosed on the basis of clinical parameters and endoscopic-histologic evaluation. 5-aminosalicylic acid (5-ASA, mesalamine) represents the first-line treatment of choice. For patients with distal and left-sided disease the use of rectal preparations is effective. Most patients respond to 5-ASA suppositories or to topic steroids such as budesonide suppositories or hydrocortisone foam. For patients with extended disease, oral medications are mandatory. In case of low- to moderate-grade inflammation, 5-ASA preparations should be implemented. In the case of severe disease treatment with steroids is required. Following induction of remission, prophylactic treatment with 5-ASA (1.5 g/d) should be maintained. For patients with frequent or severe relapses, immunosuppressive therapy with azathioprine or 6-mercaptopurine is indicated. In case of a fulminant course of disease, treatment with intravenous cyclosporine is required in patients who have not responded to high-dose intravenous steroids. When all conservative treatment options fail, proctocolectomy with construction of an ileoanal pouch should be performed. New therapeutic strategies such as infliximab and interferons are being evaluated in clinical trials. The long-term complications of ulcerative colitis include steroid-induced osteoporosis and anemia and should be treated adequately. Finally, the risk for development of colorectal cancer increases steadily with disease duration and dysplasia should be screened for by endoscopic surveillance programs.

Administration, Oral↗

PubMedDate not supplied

[Ulcerative colitis].

Ulcerative colitis in children has been seldom described in Chile. The cases of a 14 year old girl and a 10 year old boy with this disease are presented. Both had diarrhea for more than two months--which was continuous in the first case and intermittent in the other one--, bloody stools, weight loss, anemia and abdominal pain. Bacteriological and parasitological examination of stools were negative. Diagnosis of ulcerative colitis was based on barium enema, which showed mucosal ulceration and loss of the normal claustral pattern, rectosigmoidoscopy, that revealed hyperemia, friability and erosions of the corresponding segments of intestinal mucosa, and on histological examination of multiple mucosal biopsies, which disclosed crypt abscess, distorted crypt pattern, inflammation of the lamina propria and decreased number of goblet cells. Both cases were treated with salazosulfapyridine with satisfactory response.

Adolescent↗

PubMed2003

Murine models of ulcerative colitis.

Ulcerative colitis (UC) is an inflammatory bowel disease of unknown etiology limited to the large intestine. The disease is prevalent in industrial societies and is associated with specific ethnic populations. A number of murine models, each focused on distinct aspects of the disease process, were developed over the past 20 years to further our understanding of the pathogenesis of UC. These models have been and remain our best resource for the study of the disorder as a result of their homology to human UC and the ease in which they can be manipulated and examined. This review examines and distills what has been leamed from these models and how this information is related back to human UC.

Animals↗

PubMed2000

Subcutaneous abscesses in a patient with ulcerative colitis.

Ulcerative colitis (UC) is a clinical form of inflammatory bowel disease. The association of pyoderma gangrenosum or erythema nodosum with UC is well known. In addition, pustular eruption has been reported in UC. We describe a patient with UC who exhibited subcutaneous abscesses, as well as pustular eruption with a clinical course paralleling that of UC exacerbation.

Abscess↗

PubMed2003

Clinical and genetic heterogeneity in Mexican patients with ulcerative colitis.

Ulcerative colitis (UC) is an inflammatory bowel disease of unknown etiology. Genetic factors implied on its onset and severity may include genes located within the class II major histocompatibility complex (MHC) region. The aim of this study was to determine the relationship between human leukocyte antigen (HLA)-DRB1 alleles with the clinical disease patterns of UC in Mexican Mestizo patients. High-resolution HLA typing was performed by polymerase chain reaction-sequence specific oligonucleotide (PCR)-SSO reverse dot blot and PCR-single-strand polymorphism in 67 patients with UC and 99 ethnically matched healthy controls. UC patients overall showed an increased frequency of HLA-DR1 as compared with healthy controls (17.1% versus 5%, [pC = 0.003, OR = 3.9]). Patients with extensive colitis showed increased frequencies of HLA-DR1 (pC = 1 x 10(-10), OR = 13.9), HLA-DRB1*0103 (pC = 1 x 10(-3), OR = 21.7), HLA-DRB1*0102 (pC = 0.007, OR = undetermined), and HLA-DR15 (pC = 1 x 10(-3), OR = 8.5) when compared with healthy controls. We also found a statistically increased frequency of HLA-DR15 in UC patients with extensive colitis compared with UC patients with only distal colitis (18.7% versus 1.8%, pC = 0.03; OR = 12.2). When patients who underwent proctocolectomy were compared with those who did not, an increased frequency of HLA-DRB1*0103 was observed (21.8% versus 4.9%; pC = 0.03; OR = 5.4; 95% confidence interval, 1.39-21.93). Also, patients with proctocolectomy showed increased frequencies of HLA-DR1 (pC = 1 x 10(-3), OR = 24.2) and HLA-DRB1*0103 (pC = 1 x 10(-3), OR = 50.6) when compared with healthy controls. We concluded that HLA-DR1 is associated with genetic susceptibility to UC in the Mexican Mestizo population. HLA-DR15 distinguishes a subgroup of patients with extensive colitis and the HLA-DRB1*0103 allele distinguishes a subgroup of severe form of disease that might require surgical management.

Adult↗

PubMed1998

Carbonic anhydrase I reduction in colonic mucosa of patients with active ulcerative colitis.

Ulcerative colitis (UC) is associated with low intracolonic pH and unbalanced transmucosal ionic exchanges. Along the gastrointestinal tract carbonic anhydrase isoenzyme I (CA-I) is specifically expressed in colon epithelium and is involved in mucosal control of ion, fluid, and acid-base balance. Since altered CA-I expression may play some role in UC, CA-I was measured at the mRNA and protein level and carbonic anhydrase (CA) enzyme activity was determined in colon biopsies of 14 UC patients (6 remission, 4 mild, 4 moderate UC) and of 12 healthy subjects. Patients with mild or moderate UC showed a significant reduction of CA-I mRNA and protein and of total CA activity in the inflamed mucosa compared to controls. Patients with UC in remission showed a pattern of CA-I expression and CA activity similar to controls. This is the first report showing a reduction in the expression of CA-I in active UC.

Acute Disease↗

PubMed2004

Mapping of a disease susceptibility locus in chromosome 6p in Japanese patients with ulcerative colitis.

Ulcerative colitis (UC) is a multifactorial disorder with both genetic and environmental factors. HLA-B*52 and DRB1*1502 are reported to be strongly associated with UC in Japan. However, the actual susceptible gene has not been identified yet. In this study, to map precisely the susceptible locus for UC, we performed association mapping in the chromosome 6p using 24 microsatellite markers distributed over 16 Mb. A total of 183 patients with UC and 186 healthy controls (HC) were included in this study. In all, 15 markers around the human leukocyte antigen (HLA) region showed statistical significance in the genotypic differentiation test concerned with the allelic distribution between the UC and HC. Especially, the markers between the centromeric region of HLA class I and the telomeric region of class III showed remarkably low P-values and the allele239 of C2-4-4 in class I marker showed the strongest association (Pc=2.9 x 10(-9): OR=3.74, 95% CI=2.50-5.60). Furthermore, we found strong linkage disequilibrium (LD) between the allele239 of C2-4-4 and HLA-B*52 in haplotype analysis. These results provide evidence that, in Japanese, important determinants of disease susceptibility to UC may exist in HLA, especially between the centromeric region of class I and the telomeric region of class III, under the strong LD with HLA-B*52.

Adult↗

PubMed2003

Over-expression of interleukin 10 in mucosal T cells of patients with active ulcerative colitis.

Ulcerative colitis (UC), a chronic inflammatory bowel disease, exhibits pronounced increase of T lymphocytes in the inflamed mucosa. To understand the role of intestinal T lymphocytes in the pathogenesis of UC their cytokine production in the mucosa was analysed. Intestinal T lymphocytes of UC, Crohn's disease and control patients were analysed for cytokine mRNA levels by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR) directly after isolation without in vitro stimulation. Frequencies of cytokine positive cells were determined in UC and control colon by immunomorphometry. T lymphocytes in normal colon expressed interleukin (IL)-2, interferon (IFN)-gamma, tumour necrosis factor (TNF)-alpha and transforming growth factor (TGF)-beta1, but not IL-4, IL-5 or IL-10. In UC, a highly significant increase in IL-10 mRNA levels in T lymphocytes and an increased frequency of IL-10 positive cells was seen in colon. IL-10 mRNA levels were also elevated in T lymphocytes of the non-inflamed ileum and correlated with disease activity at both locations. CD4+ T lymphocytes were the major source of IL-10 mRNA. IL-2, IFN-gamma and TNF-alpha mRNA levels were decreased in colonic T lymphocytes, and virtually no IL-2, IFN-gamma, TNF-alpha or TGF-beta positive cells were detected in basal lymphoid aggregates. However, scattered IL-10 positive cells were found here. Lamina propria outside the aggregates contained IL-10-, IFN-gamma, TNF-alpha and TGF-beta but not IL-2 positive cells. T cells of UC patients did not express IL-4 or IL-5. Taken, together the data suggest a generalized activation of IL-10 producing CD4+ T cells along the intestine of UC patients. The local environment seems to determine the biological consequences of elevated IL-10.

Acute Disease↗