Gastroenterology & Nutrition

Ulcerative Colitis

A chronic inflammatory colitis that usually begins in the rectum and extends continuously proximally, producing bloody diarrhoea and urgency; severity determines whether the pathway is outpatient induction, specialist escalation or acute severe colitis admission.

Definition

Ulcerative colitis is a chronic relapsing inflammatory bowel disease affecting the colon and rectum, usually with continuous mucosal inflammation beginning in the rectum and extending proximally to a variable extent.

First principles

Extent and depth explain the phenotype

Ulcerative colitis is an inflammatory bowel disease of the colon and rectum, usually continuous from the rectum proximally and predominantly mucosal. Extent predicts stool frequency, urgency, surveillance needs and treatment delivery, while severe inflammation can impair colonic motility and cause toxic megacolon despite not being transmural.

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