Name
ULCERATIVE COLITIS
DESCRIPTION
DETAIL
D.D. : * CROHNS DISEASE * INFECTIONS OF SMALL INTESTINE OR COLON A. BACTERIAL * CAMPYLOBACTOR * SALMONELLA * SHIGELLOSIS * YERSINIA ENTEROCOLITICA * CORNYBACTER DIFFICILE * ESCHERICHIA COLI * MYCOBACTERIUM AVIUM INTRACELLULARE & M. TUBERCULOSIS * RARELY GONORRHEA, CLAMYDIA & SYPHILIS CAUSE PROCTITIS B. VIRAL * CYTOMEGALOVIRUS * HERPES SIMPLEX C. FUNGAL * CANDIDA * ASPERGILLUS * DISSEMINATED HISTOPLASMOSIS D. PROTOZOAL OR PARASITIC * ENTAMOEBA HISTOLYTICA * ISOSPORA BELLI * HOOK WORM * WHIP WORM * STRONGYLOIDES INFECTION E. NONINFECTIOUS DISEASES * DIVERTICULITIS * RADIATION COLITIS * ISCHAEMIC COLITIS * SOLITARY RECTAL ULCER SYNDROME * NSAIDS ASSOCIATED COLITIS * COLLAGENOUS COLITIS * LYMPHOCYTIC COLITIS * DIVERSION COLITISOTHER TESTS : * COLONOSCOPY * BLOOD TEST - ESR , C- REACTIVE PROTEIN , OROSOMUCOID LEVELS , PLATELETS - RAISED * SERUM PROTEINS - DECREASED IN SEVERELY ILL PATIENTS * PLAIN X-RAY ABDOMEN : - IN SEVERE DISEASE - MARGINS OF COLON EDEMATOUS & IRREGULAR. COLONIC THICKENING & TOXIC DILATATION OF COLON. - SINGLE CONTRAST BARIUM ENEMA - FINE MUCOSAL GRANULARITY , MUCOSAL THICKENING & SUPERFICIAL ULCERS. DEEP ILCERS ARE COLLAR STUD TYPE. HAUSTRAL FOLDS NORMAL IN MILD CASES, BUT EDEMATOUS & THICHENED IN PROGRESSIVE DISEASE. LOSS OF HAUSTRATION IN CHR. DISEASE & LATER ON SHORT & NARROWED COLON. * Two serologic tests are available to attempt to differentiate ulcerative colitis from Crohn disease. o Perinuclear antineutrophil cytoplasmic antibody (p-ANCA), a myeloperoxidase antigen, is more commonly found in UC, whereas antibodies to the yeast Saccharomyces cerevisiae (ie, anti-S cerevisiae antibodies [ASCA]) are more commonly found in Crohn disease. o Therefore, a test result positive for p-ANCA antigen and negative for ASCA suggests the diagnosis of UC; conversely, a test result positive for ASCA and negative for p-ANCA antigen suggests the presence of Crohn disease. o However, these tests are only recommended as an adjunct to clinical diagnosis, as the test results are not specific and have been found to be positive in other bowel diseases.
TYPENOTES
Surgical Care: Considerations for total colectomy are as follows: " Evidence of carcinoma or dysplasia " Chronic refractory ulcerative colitis " Severe hemorrhage or perforation " Toxic megacolon cases that do not improve within 48-72 hours " Obstruction due to stricture (be suspicious of cancer) " Fulminant colitis not responsive to treatment " Systemic complications " Failure to thrive in CHILDREN DRUG TREATMENT : 1. AMINOSALICYLATES : - SULFASALAZINE - MESALAMINE - BALSALAZIDE - OLSALAZINE 2. IMMNOSUPPRESSANTS : - AZATHIOPRINE - CYCLOSPORINE 3. CORTICOSTEROIDS : - PREDNISONE - METHYL PREDNISOLONE 4. ANTIMICROBIALS : - CIPROFLOXACIN - METRANIDAZOLE 5. ANTI-TUMOR NECROSIS FACTOR AGENTS : - INFLIXIMAB 5. H-2 RECEPTOR ANTAGONISTS / PROTON PUMP INHIBITORS : - CIMETIDINE - RANITIDINE - FAMOTIDINE - NIZATIDINE - OMEPRAZOLE - RABEPRAZOLE - LANSOPRAZOLE - ESOMEPRAZOLE - PANTOPRAZOLE 6. ANTIDIARRHOEAL AGENTS : - LOPERAMIDE - DIPHENOXILATE & ATROPINE ( LOMOTIL ) - CHOLESTYRAMINE 7. ANTISPASMODIC AGENTS : - DICYCLOMINE
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
SERUM PROTEIN TOTAL, C-REACTIVE PROTEIN, X-RAY ABDOMEN A.P. VIEW FOR KUB, X-RAY BARIUM ENEMA, COMPLETE BLOOD COUNT, COLONOSCOPY