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Ulcerative colitis
1.
2. INTRODUCTION
Ulcerative colitis is a disease that causes
inflammation and sores, called ulcers, in the
lining of the rectum and colon
The main symptom of active disease is
usually constant diarrhea mixed with
blood, of gradual onset. is a form of
inflammatory bowel disease (IBD)
. Ulcerative colitis is a form of colitis, a
disease of the intestine, specifically the
large intestine or colon, that includes
characteristic ulcers, or open sores, in the
colon
3. The most common symptoms of ulcerative colitis
are abdominal pain and bloody diarrhea. Patients
also may experience
anemia
fatigue
weight loss
loss of appetite
rectal bleeding
loss of body fluids and nutrients
skin lesions
joint pain
growth failure (specifically in children)
4. Many tests are used to diagnose
ulcerative colitis. A physical exam and
medical history are usually the first step.
Blood tests may be done to check for
anemia, which could indicate bleeding in
the colon or rectum .
In addition, a stool sample allows the
doctor to detect bleeding or infection in
the colon or rectum caused by bacteria, a
virus, or parasites.
5. While the cause of ulcerative
colitis is still
unknown, several, possibly
interrelated, causes have been
suggested
1. GENITIC FACTORS
2. ENVIRONMENTAL FACTORS
3. AUTO IMMUNE DISEASE
4. ALTERNATIVE THEORIES
6. CLINICAL
PRESENTATION
GISYMPTOMS
EXTENT OF INVOLVMENT
SEVIERITY OF DISEASE
EXTRAINTISTINAL FEATURES
8. MESALAZINE
MECHANISM ACTION
These include the inhibition of cyclo-
oxygenase, lipoxygenase, platelet-activating
factor, interleukin-1, nuclear factor κB, tumour
necrosis factor activation, B cells and oxygen
radical production, and a ‘scavenger of
reactive oxygen species’
9. PHARMACOKINETICS
The range of urinary excretion for the azo-bond
compounds and Asacol ranged between 10% and
35%,
for Pentasa, between 15% and 53%, and, for
Salofalk /Claversal/Mesasal, between 27% and 56%.
all compounds showed comparable ranges of
systemic absorption of total 5-ASA based on
plasma pharmacokinetics,
24–96-h urinary excretion of total 5-ASA and
faecal excretion
10. COURSE AND
COMPLICATIONS
• Patients with proctitis or left-sided colitis
usually have a more benign course: only 15%
progress proximally with their disease, and up to
20% can have sustained remission in the
absence of any therapy
• Patients with more extensive disease are less
likely to sustain remission, but the rate of
remission is independent of the severity of
disease.
11. Recent evidence from the ACT-1 trial suggests
that infliximab may have a greater role in
inducing and maintaining disease remission
An increased amount of colonic sulfate-
reducing bacteria has been observed in some
patients with ulcerative colitis, resulting in
higher concentrations of the toxic gas hydrogen
sulfide.
The role of hydrogen sulfide in pathogenesis is
unclear