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Ulcerative Colitis Pathology

Overview

Ulcerative colitis (UC) is one of the idiopathic forms of inflammatory bowel disease (IBD), sharing this designation with Crohn disease (CD). Ulcerative colitis is a chronic, relapsing inflammatory disease of the colon, and affected patients may exhibit inflammation from cecum to rectum (see the following image). Symptoms may include abdominal pain, malnutrition, and diarrhea, often bloody.

Chronic architectural changes in ulcerative coliti

Chronic architectural changes in ulcerative colitis (UC). One can see crypt branching and irregularity of size and shape, with an increase in chronic inflammatory cells in the lamina propria.

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Patients with ulcerative colitis are at increased risk for dysplasia and adenocarcinoma of the colon,
and they require lifelong, regular endoscopic surveillance. Approximately 25-30% of patients with this condition will require colectomy at some point in their lives if treatment with medications is not successful or if dysplasia, a precursor lesion to carcinoma, is found. Colectomy is considered curative for ulcerative colitis.

A detailed explanation of treatment for ulcerative colitis is beyond the scope of this discussion. Briefly, the goals of treatment are to decrease symptoms and improve quality of life. Therapeutic interventions may include 1 or more medications, dietary modifications, and supportive care during disease flares. In addition, many affected patients (25-30%) will require surgery at some point in their lives.

See also the following:

Crohn Disease Pathology

Inflammatory Bowel Disease

Complications of Inflammatory Bowel Disease

Pediatric Crohn Disease

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