Form of inflammatory bowel disease that affects the rectum and extends proximally. Characterized by diffuse inflammation of the colonic mucosa and a relapsing, remitting course.
Patients commonly experience bloody diarrhea, chronic diarrhea (or both), lower abdominal pain, fecal urgency, and extraintestinal manifestations, particularly those related to activity of the colitis.
Diagnosis requires endoscopy with biopsy and negative stool culture.
Relapses are often associated with pathogens; therefore, stool should be obtained for culture in all cases of disease flare-up.
Treatment aims to induce and maintain remission. Drug choice and formulation depends on the severity and extent of disease.
Toxic megacolon can occur with associated risk of perforation. Bowel adenocarcinoma is a complication in 3% to 5% of patients.
Ulcerative colitis (UC) is a type of inflammatory bowel disease that characteristically involves the rectum and extends proximally to affect a variable length of the colon. It is recognized as a multifactorial polygenic disease, as the exact etiology is still unknown. Included in the etiologic theories are environmental factors, immune dysfunction, and a likely genetic predisposition.   
Clinical Research Fellow
St George’s Hospital
AS declares that she has no competing interests.
Department of Gastroenterology
St George’s Hospital
AP is an author of a reference cited in this monograph.
Dr Anet Soubieres and Dr Andrew Poullis would like to gratefully acknowledge Dr Rhys Hewett, Dr Willem J.S. de Villiers, and Dr Houssam Mardini, the previous contributors to this monograph. RH, WJSD, and HM declare that they have no competing interests.
Associate Professor of Medicine
Division of Digestive Diseases and Nutrition
University of Kentucky
TW declares that he has no competing interests.
Assistant Professor of Surgery
Division of Colon and Rectal Surgery
University Hospital Case Medical Center
SS received a fee for educational courses on laparoscopic surgery, paid for in part by Covidien, Olympus, and Applied Medical.
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