Rapid Review: Ulcerative Colitis

Ulcerative Colitis

• Patient will be 15–30 years old
• Complaining of bloody diarrhea, crampy abdominal pain, and tenesmus
• Colonoscopy will show continuous mucosal inflammation always involving the rectum
• Treatment is sulfasalazine, surgery is curative
• Complications: Toxic megacolon, ↑ colon cancer risk

Sample question:

A 32-year-old man presents to clinic with worsening colicky stomach pains, and bloody, mucous streaked diarrhea. He reports he has no fever, nausea or vomiting. His symptoms began vaguely a week ago and have progressed in severity since then. He reports he is otherwise healthy, not on any medications and has not traveled recently. He has no family history of colon cancer and reports the symptoms are so bad he is no longer able to go out in public for fear of having to use the toilet. Stool studies are negative. Colonoscopy reveals edema, friability, mucous and erosions of the mucosal surface of the rectosigmoid region. Which of the following is the most likely diagnosis?