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Ulcerative colitis

MedGen UID:
3532
Concept ID:
C0009324
Disease or Syndrome
Synonyms: Colitis Gravis; Colitis, Ulcerative; Idiopathic Proctocolitis; Inflammatory Bowel Disease, Ulcerative Colitis Type; Ulcerative Colitis
SNOMED CT: Colitis gravis (64766004); Ulcerative colitis (64766004); Idiopathic proctocolitis (64766004); UC - ulcerative colitis (64766004)
 
HPO: HP:0100279
Monarch Initiative: MONDO:0005101
OMIM®: 266600
Orphanet: ORPHA771

Definition

A chronic inflammatory bowel disease that includes characteristic ulcers, or open sores, in the colon. The main symptom of active disease is usually constant diarrhea mixed with blood, of gradual onset and intermittent periods of exacerbated symptoms contrasting with periods that are relatively symptom-free. In contrast to Crohn's disease this special form of colitis begins in the distal parts of the rectum, spreads continually upwards and affects only mucose and submucose tissue of the colon. [from HPO]

Clinical features

From HPO
Abdominal pain
MedGen UID:
7803
Concept ID:
C0000737
Sign or Symptom
An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) and perceived to originate in the abdomen.
Growth delay
MedGen UID:
99124
Concept ID:
C0456070
Pathologic Function
A deficiency or slowing down of growth pre- and postnatally.
Weight loss
MedGen UID:
853198
Concept ID:
C1262477
Finding
Reduction of total body weight.
Ulcerative colitis
MedGen UID:
3532
Concept ID:
C0009324
Disease or Syndrome
A chronic inflammatory bowel disease that includes characteristic ulcers, or open sores, in the colon. The main symptom of active disease is usually constant diarrhea mixed with blood, of gradual onset and intermittent periods of exacerbated symptoms contrasting with periods that are relatively symptom-free. In contrast to Crohn's disease this special form of colitis begins in the distal parts of the rectum, spreads continually upwards and affects only mucose and submucose tissue of the colon.
Crohn disease
MedGen UID:
3664
Concept ID:
C0010346
Disease or Syndrome
A chronic granulomatous inflammatory disease of the intestines that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms. It primarily causes abdominal pain, diarrhea which may be bloody, vomiting, or weight loss, but may also cause complications outside of the gastrointestinal tract such as skin rashes, arthritis, inflammation of the eye, tiredness, and lack of concentration. Crohn's disease is thought to be an autoimmune disease, in which the body's immune system attacks the gastrointestinal tract, causing inflammation.
Diarrhea
MedGen UID:
8360
Concept ID:
C0011991
Sign or Symptom
Abnormally increased frequency (usually defined as three or more) loose or watery bowel movements a day.
Intestinal obstruction
MedGen UID:
43933
Concept ID:
C0021843
Disease or Syndrome
Blockage or impairment of the normal flow of the contents of the intestine towards the anal canal.
Inflammation of the large intestine
MedGen UID:
662273
Concept ID:
C0578878
Disease or Syndrome
Inflammation, or an inflammatory state in the large intestine.
Aphthous stomatitis
MedGen UID:
20959
Concept ID:
C0038363
Disease or Syndrome
Oral aphthous ulcers typically present as painful, sharply circumscribed fibrin-covered mucosal defects with a hyperemic border.
Recurrent aphthous stomatitis
MedGen UID:
445425
Concept ID:
C2937365
Disease or Syndrome
Recurrent episodes of ulceration of the oral mucosa, typically presenting as painful, sharply circumscribed fibrin-covered mucosal defects with a hyperemic border.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVUlcerative colitis

Conditions with this feature

Ulcerative colitis
MedGen UID:
3532
Concept ID:
C0009324
Disease or Syndrome
A chronic inflammatory bowel disease that includes characteristic ulcers, or open sores, in the colon. The main symptom of active disease is usually constant diarrhea mixed with blood, of gradual onset and intermittent periods of exacerbated symptoms contrasting with periods that are relatively symptom-free. In contrast to Crohn's disease this special form of colitis begins in the distal parts of the rectum, spreads continually upwards and affects only mucose and submucose tissue of the colon.
Wiskott-Aldrich syndrome
MedGen UID:
21921
Concept ID:
C0043194
Disease or Syndrome
The WAS-related disorders, which include Wiskott-Aldrich syndrome, X-linked thrombocytopenia (XLT), and X-linked congenital neutropenia (XLN), are a spectrum of disorders of hematopoietic cells, with predominant defects of platelets and lymphocytes caused by pathogenic variants in WAS. WAS-related disorders usually present in infancy. Affected males have thrombocytopenia with intermittent mucosal bleeding, bloody diarrhea, and intermittent or chronic petechiae and purpura; eczema; and recurrent bacterial and viral infections, particularly of the ear. At least 40% of those who survive the early complications develop one or more autoimmune conditions including hemolytic anemia, immune thrombocytopenic purpura, immune-mediated neutropenia, rheumatoid arthritis, vasculitis, and immune-mediated damage to the kidneys and liver. Individuals with a WAS-related disorder, particularly those who have been exposed to Epstein-Barr virus (EBV), are at increased risk of developing lymphomas, which often occur in unusual, extranodal locations including the brain, lung, or gastrointestinal tract. Males with XLT have thrombocytopenia with small platelets; other complications of Wiskott-Aldrich syndrome, including eczema and immune dysfunction, are usually mild or absent. Males with XLN have congenital neutropenia, myeloid dysplasia, and lymphoid cell abnormalities.
Inflammatory bowel disease 3
MedGen UID:
346785
Concept ID:
C1858303
Disease or Syndrome
An inflammatory bowel disease that has material basis in variation in the chromosome region 6p21.3.
Inflammatory bowel disease 21
MedGen UID:
436705
Concept ID:
C2676507
Disease or Syndrome
An inflammatory bowel disease that has material basis in variation in the chromosome region 18p11.
Immunodeficiency due to MASP-2 deficiency
MedGen UID:
462435
Concept ID:
C3151085
Disease or Syndrome
MASP2 deficiency, classically defined as MASP2 protein level of less than 100 ng/ml, occurs in about 4% of Caucasians and up to 18% of some African populations. Some MASP2-deficient individuals have increased risk of infection or autoimmune disease, but most are asymptomatic. MASP2 plays a role in activation of the lectin pathway of the complement system; deficiency may thus lead to defects in the complement system (summary by Thiel et al., 2007 and Sokolowska et al., 2015). For a discussion of genetic heterogeneity of lectin complement activation pathway defects, see LCAPD1 (614372).
Autoinflammation-PLCG2-associated antibody deficiency-immune dysregulation
MedGen UID:
766875
Concept ID:
C3553961
Disease or Syndrome
Autoinflammation, antibody deficiency, and immune dysregulation (APLAID) is an autosomal dominant systemic disorder characterized by recurrent blistering skin lesions with a dense inflammatory infiltrate and variable involvement of other tissues, including joints, the eye, and the gastrointestinal tract. Affected individuals have a mild humoral immune deficiency associated with recurrent sinopulmonary infections, but no evidence of circulating autoantibodies (summary by Zhou et al., 2012).
Frontometaphyseal dysplasia 2
MedGen UID:
934664
Concept ID:
C4310697
Disease or Syndrome
Frontometaphyseal dysplasia (FMD) is a progressive sclerosing skeletal dysplasia characterized by supraorbital hyperostosis, undermodeling of the small bones, and small and large joint contractures, as well as extraskeletal developmental abnormalities, primarily of the cardiorespiratory system and genitourinary tract. Patients with FMD2 appear to have a propensity for keloid formation (summary by Wade et al., 2016). For a discussion of genetic heterogeneity of frontometaphyseal dysplasia, see FMD1 (305620).
Immunodeficiency 11b with atopic dermatitis
MedGen UID:
1627819
Concept ID:
C4539957
Disease or Syndrome
IMD11B is an autosomal dominant disorder of immune dysfunction characterized by onset of moderate to severe atopic dermatitis in early childhood. Some patients may have recurrent infections and other variable immune abnormalities. Laboratory studies show defects in T-cell activation, increased IgE, and eosinophilia (summary by Ma et al., 2017).
Inflammatory bowel disease 29
MedGen UID:
1648318
Concept ID:
C4748083
Disease or Syndrome
Inflammatory bowel disease is a chronic inflammatory condition of the gastrointestinal tract (summary by Mohanan et al., 2018). For a general description and a discussion of genetic heterogeneity of inflammatory bowel disease, including Crohn disease (CD) and ulcerative colitis (UC), see IBD1 (266600).
Immunodeficiency 60
MedGen UID:
1681890
Concept ID:
C5193072
Disease or Syndrome
Immunodeficiency-60 and autoimmunity (IMD60) is an autosomal dominant primary immunologic disorder characterized by inflammatory bowel disease and recurrent sinopulmonary infections. The age at symptom onset is highly variable, ranging from infancy to mid-adulthood. Laboratory studies show dysregulation of both B and T cells, with variably decreased immunoglobulin production, decreased T-regulatory cells, and overall impaired lymphocyte maturation (summary by Afzali et al., 2017).
Granulomatous disease, chronic, autosomal recessive, 5
MedGen UID:
1710326
Concept ID:
C5394542
Disease or Syndrome
Chronic granulomatous disease (CGD) is a primary immunodeficiency disorder of phagocytes (neutrophils, monocytes, macrophages, and eosinophils) resulting from impaired killing of bacteria and fungi. CGD is characterized by severe recurrent bacterial and fungal infections and dysregulated inflammatory responses resulting in granuloma formation and other inflammatory disorders such as colitis. Infections typically involve the lung (pneumonia), lymph nodes (lymphadenitis), liver (abscess), bone (osteomyelitis), and skin (abscesses or cellulitis). Granulomas typically involve the genitourinary system (bladder) and gastrointestinal tract (often the pylorus initially, and later the esophagus, jejunum, ileum, cecum, rectum, and perirectal area). Some males with X-linked CGD have McLeod neuroacanthocytosis syndrome as the result of a contiguous gene deletion. While CGD may present anytime from infancy to late adulthood, the vast majority of affected individuals are diagnosed before age five years. Use of antimicrobial prophylaxis and therapy has greatly improved overall survival.
Inflammatory bowel disease (infantile ulcerative colitis) 31, autosomal recessive
MedGen UID:
1783277
Concept ID:
C5444224
Disease or Syndrome
Infantile ulcerative colitis (IBD31) is characterized by the presence of ulcers throughout the colon and rectum with normal-appearing ileum. Affected infants present with recurrent bloody diarrhea with anemia and leukocytosis, with extensive lymphoplasmocytic infiltration, cryptitis, and apoptotic crypt abcesses throughout the colon and rectum (Zhang et al., 2021). Infantile bowel disease has also been referred to as very-early-onset IBD (VEOIBD). For a general description and discussion of genetic heterogeneity of inflammatory bowel disease, including Crohn disease (CD) and ulcerative colitis, see IBD1 (266600).

Professional guidelines

PubMed

Rogler G, Singh A, Kavanaugh A, Rubin DT
Gastroenterology 2021 Oct;161(4):1118-1132. Epub 2021 Aug 3 doi: 10.1053/j.gastro.2021.07.042. PMID: 34358489Free PMC Article
Lamb CA, Kennedy NA, Raine T, Hendy PA, Smith PJ, Limdi JK, Hayee B, Lomer MCE, Parkes GC, Selinger C, Barrett KJ, Davies RJ, Bennett C, Gittens S, Dunlop MG, Faiz O, Fraser A, Garrick V, Johnston PD, Parkes M, Sanderson J, Terry H; IBD guidelines eDelphi consensus group, Gaya DR, Iqbal TH, Taylor SA, Smith M, Brookes M, Hansen R, Hawthorne AB
Gut 2019 Dec;68(Suppl 3):s1-s106. Epub 2019 Sep 27 doi: 10.1136/gutjnl-2019-318484. PMID: 31562236Free PMC Article
Seyedian SS, Nokhostin F, Malamir MD
J Med Life 2019 Apr-Jun;12(2):113-122. doi: 10.25122/jml-2018-0075. PMID: 31406511Free PMC Article

Curated

UK NICE Clinical Guideline CG118, Colorectal cancer prevention: colonoscopic surveillance in adults with ulcerative colitis, Crohn's disease or adenomas, 2022

UK NICE Guideline NG193, Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain, 2021

Recent clinical studies

Etiology

Radziszewska M, Smarkusz-Zarzecka J, Ostrowska L, Pogodziński D
Nutrients 2022 Jun 14;14(12) doi: 10.3390/nu14122469. PMID: 35745199Free PMC Article
Fabián O, Kamaradová K
Cesk Patol 2022 Spring;58(1):27-37. PMID: 35387455
Kucharzik T, Koletzko S, Kannengiesser K, Dignass A
Dtsch Arztebl Int 2020 Aug 17;117(33-34):564-574. doi: 10.3238/arztebl.2020.0564. PMID: 33148393Free PMC Article
Keshteli AH, Madsen KL, Dieleman LA
Nutrients 2019 Jun 30;11(7) doi: 10.3390/nu11071498. PMID: 31262022Free PMC Article
Adams SM, Bornemann PH
Am Fam Physician 2013 May 15;87(10):699-705. PMID: 23939448

Diagnosis

Fabián O, Kamaradová K
Cesk Patol 2022 Spring;58(1):27-37. PMID: 35387455
Segal JP, LeBlanc JF, Hart AL
Clin Med (Lond) 2021 Mar;21(2):135-139. doi: 10.7861/clinmed.2021-0080. PMID: 33762374Free PMC Article
Kucharzik T, Koletzko S, Kannengiesser K, Dignass A
Dtsch Arztebl Int 2020 Aug 17;117(33-34):564-574. doi: 10.3238/arztebl.2020.0564. PMID: 33148393Free PMC Article
Kaenkumchorn T, Wahbeh G
Gastroenterol Clin North Am 2020 Dec;49(4):655-669. Epub 2020 Sep 23 doi: 10.1016/j.gtc.2020.07.001. PMID: 33121687
Keshteli AH, Madsen KL, Dieleman LA
Nutrients 2019 Jun 30;11(7) doi: 10.3390/nu11071498. PMID: 31262022Free PMC Article

Therapy

Paik J
Drugs 2022 Aug;82(12):1303-1313. Epub 2022 Aug 22 doi: 10.1007/s40265-022-01762-8. PMID: 35994200Free PMC Article
Napolitano M, D'Amico F, Ragaini E, Peyrin-Biroulet L, Danese S
Drug Des Devel Ther 2022;16:1897-1913. Epub 2022 Jun 17 doi: 10.2147/DDDT.S340459. PMID: 35747444Free PMC Article
Sandborn WJ, Feagan BG, D'Haens G, Wolf DC, Jovanovic I, Hanauer SB, Ghosh S, Petersen A, Hua SY, Lee JH, Charles L, Chitkara D, Usiskin K, Colombel JF, Laine L, Danese S; True North Study Group
N Engl J Med 2021 Sep 30;385(14):1280-1291. doi: 10.1056/NEJMoa2033617. PMID: 34587385
Berg DR, Colombel JF, Ungaro R
Inflamm Bowel Dis 2019 Nov 14;25(12):1896-1905. doi: 10.1093/ibd/izz059. PMID: 30934053Free PMC Article
Schroeder KW, Tremaine WJ, Ilstrup DM
N Engl J Med 1987 Dec 24;317(26):1625-9. doi: 10.1056/NEJM198712243172603. PMID: 3317057

Prognosis

Agrawal M, Jess T
United European Gastroenterol J 2022 Dec;10(10):1113-1120. Epub 2022 Oct 17 doi: 10.1002/ueg2.12317. PMID: 36251359Free PMC Article
Park J, Cheon JH
Yonsei Med J 2021 Feb;62(2):99-108. doi: 10.3349/ymj.2021.62.2.99. PMID: 33527789Free PMC Article
Du L, Ha C
Gastroenterol Clin North Am 2020 Dec;49(4):643-654. Epub 2020 Sep 25 doi: 10.1016/j.gtc.2020.07.005. PMID: 33121686
Ananthakrishnan AN
Nat Rev Gastroenterol Hepatol 2015 Apr;12(4):205-17. Epub 2015 Mar 3 doi: 10.1038/nrgastro.2015.34. PMID: 25732745
da Silva BC, Lyra AC, Rocha R, Santana GO
World J Gastroenterol 2014 Jul 28;20(28):9458-67. doi: 10.3748/wjg.v20.i28.9458. PMID: 25071340Free PMC Article

Clinical prediction guides

Rogler G, Singh A, Kavanaugh A, Rubin DT
Gastroenterology 2021 Oct;161(4):1118-1132. Epub 2021 Aug 3 doi: 10.1053/j.gastro.2021.07.042. PMID: 34358489Free PMC Article
Jukic A, Bakiri L, Wagner EF, Tilg H, Adolph TE
Gut 2021 Oct;70(10):1978-1988. Epub 2021 Jun 18 doi: 10.1136/gutjnl-2021-324855. PMID: 34145045Free PMC Article
Yashiro M
World J Gastroenterol 2014 Nov 28;20(44):16389-97. doi: 10.3748/wjg.v20.i44.16389. PMID: 25469007Free PMC Article
da Silva BC, Lyra AC, Rocha R, Santana GO
World J Gastroenterol 2014 Jul 28;20(28):9458-67. doi: 10.3748/wjg.v20.i28.9458. PMID: 25071340Free PMC Article
Uhlig HH, Schwerd T, Koletzko S, Shah N, Kammermeier J, Elkadri A, Ouahed J, Wilson DC, Travis SP, Turner D, Klein C, Snapper SB, Muise AM; COLORS in IBD Study Group and NEOPICS
Gastroenterology 2014 Nov;147(5):990-1007.e3. Epub 2014 Jul 21 doi: 10.1053/j.gastro.2014.07.023. PMID: 25058236Free PMC Article

Recent systematic reviews

Buie MJ, Quan J, Windsor JW, Coward S, Hansen TM, King JA, Kotze PG, Gearry RB, Ng SC, Mak JWY, Abreu MT, Rubin DT, Bernstein CN, Banerjee R, Yamamoto-Furusho JK, Panaccione R, Seow CH, Ma C, Underwood FE, Ahuja V, Panaccione N, Shaheen AA, Holroyd-Leduc J, Kaplan GG; Global IBD Visualization of Epidemiology Studies in the 21st Century (GIVES-21) Research Group, Balderramo D, Chong VH, Juliao-Baños F, Dutta U, Simadibrata M, Kaibullayeva J, Sun Y, Hilmi I, Raja Ali RA, Paudel MS, Altuwaijri M, Hartono JL, Wei SC, Limsrivilai J, El Ouali S, Vergara BI, Dao VH, Kelly P, Hodges P, Miao Y, Li M
Clin Gastroenterol Hepatol 2023 Aug;21(9):2211-2221. Epub 2022 Jul 19 doi: 10.1016/j.cgh.2022.06.030. PMID: 35863682
Lasa JS, Olivera PA, Danese S, Peyrin-Biroulet L
Lancet Gastroenterol Hepatol 2022 Feb;7(2):161-170. Epub 2021 Nov 29 doi: 10.1016/S2468-1253(21)00377-0. PMID: 34856198
Turner D, Ricciuto A, Lewis A, D'Amico F, Dhaliwal J, Griffiths AM, Bettenworth D, Sandborn WJ, Sands BE, Reinisch W, Schölmerich J, Bemelman W, Danese S, Mary JY, Rubin D, Colombel JF, Peyrin-Biroulet L, Dotan I, Abreu MT, Dignass A; International Organization for the Study of IBD
Gastroenterology 2021 Apr;160(5):1570-1583. Epub 2021 Feb 19 doi: 10.1053/j.gastro.2020.12.031. PMID: 33359090
Singh S, Murad MH, Fumery M, Dulai PS, Sandborn WJ
Clin Gastroenterol Hepatol 2020 Sep;18(10):2179-2191.e6. Epub 2020 Jan 13 doi: 10.1016/j.cgh.2020.01.008. PMID: 31945470Free PMC Article
Ng SC, Shi HY, Hamidi N, Underwood FE, Tang W, Benchimol EI, Panaccione R, Ghosh S, Wu JCY, Chan FKL, Sung JJY, Kaplan GG
Lancet 2017 Dec 23;390(10114):2769-2778. Epub 2017 Oct 16 doi: 10.1016/S0140-6736(17)32448-0. PMID: 29050646

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      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    • NICE, 2022
      UK NICE Clinical Guideline CG118, Colorectal cancer prevention: colonoscopic surveillance in adults with ulcerative colitis, Crohn's disease or adenomas, 2022
    • NICE, 2021
      UK NICE Guideline NG193, Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain, 2021

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