Editing Ulcerative colitis (section)

{{Short description|Inflammatory bowel disease that causes ulcers in the colon}}
{{Use dmy dates|date=September 2024}}
{{cs1 config |name-list-style=vanc |display-authors=6}}
{{Infobox medical condition (new)
| name          = Ulcerative colitis
| image         = UC granularity.png
| caption       = [[Endoscopic]] image of a colon affected by ulcerative colitis. The internal surface of the colon is blotchy and broken in places. Mild-moderate disease.
| symptoms      = [[Abdominal pain]], [[diarrhea]] mixed with [[blood]], [[weight loss]], [[fever]], [[anemia]],<ref name=NIH2014/> [[dehydration]], loss of appetite, [[fatigue]], sores on the skin, urgency to defecate, inability to defecate despite urgency, [[rectal pain]]<ref name="AR">{{cite web |title=Ulcerative Colitis |url=https://www.autoimmuneregistry.org/ulcerative-colitis |archive-url=https://web.archive.org/web/20181029163447/http://www.autoimmuneregistry.org/ulcerative-colitis/ |url-status=dead |archive-date=29 October 2018 |access-date=15 June 2022 |website=Autoimmune Registry Inc. }}</ref>
| field         = [[Gastroenterology]]
| complications = [[Megacolon]], inflammation of the eye, joints, or liver, [[colon cancer]]<ref name=NIH2014/><ref name=Wan2016/>
| onset         = 15–30 years or >60 years<ref name=NIH2014/>
| duration      = Long term<ref name=NIH2014/>
| types         =
| causes        = Unknown<ref name=NIH2014/>
| risks         =
| diagnosis     = [[Colonoscopy]] with [[tissue biopsies]]<ref name=NIH2014/>
| differential  = [[Dysentery]], [[Crohn's disease]], [[ischemic colitis]]<ref>{{cite book| vauthors = Runge MS, Greganti MA | title = Netter's Internal Medicine E-Book|date=2008|publisher=Elsevier Health Sciences|isbn=9781437727722|page=428|url=https://books.google.com/books?id=hiIPDQAAQBAJ&pg=PA428|language=en}}</ref>
| prevention    =
| treatment     = Dietary changes, medication, surgery<ref name=NIH2014/>
| medication    = [[Sulfasalazine]], [[mesalazine]], [[corticosteroids|steroids]], [[immunosuppressants]] such as [[azathioprine]], [[Biological therapy for inflammatory bowel disease|biological therapy]]<ref name=NIH2014/>
| prognosis     =
| frequency     = 2&ndash;299 per 100,000<ref name=Molodecky />
| deaths        = 47,400 together with Crohn's (2015)<ref name=GBD2015De />
| alt           =
}}

'''Ulcerative colitis''' ('''UC''') is one of the two types of [[inflammatory bowel disease]] (IBD), with the other type being [[Crohn's disease]].<ref name=NIH2014/> It is a [[chronic condition|long-term condition]] that results in [[inflammation]] and [[ulcer]]s of the [[Large intestine#Structure|colon]] and [[rectum]].<ref name=NIH2014 /><ref name=BMJ2013 /> The primary symptoms of active disease are [[abdominal pain]] and [[diarrhea]] mixed with [[blood]] ([[hematochezia]]).<ref name="NIH2014" /> [[Weight loss]], [[fever]], and [[anemia]] may also occur.<ref name="NIH2014" /> Often, symptoms come on slowly and can range from mild to severe.<ref name="NIH2014" /> Symptoms typically occur intermittently with periods of no symptoms between flares.<ref name="NIH2014" /> Complications may include abnormal dilation of the colon ([[megacolon]]), inflammation of the eye, joints, or liver, and [[colon cancer]].<ref name=NIH2014/><ref name=Wan2016>{{cite journal | vauthors = Wanderås MH, Moum BA, Høivik ML, Hovde Ø | title = Predictive factors for a severe clinical course in ulcerative colitis: Results from population-based studies | journal = World Journal of Gastrointestinal Pharmacology and Therapeutics | volume = 7 | issue = 2 | pages = 235–241 | date = May 2016 | pmid = 27158539 | pmc = 4848246 | doi = 10.4292/wjgpt.v7.i2.235 | doi-access = free }}</ref>

The cause of UC is unknown.<ref name=NIH2014/> Theories involve [[autoimmune disease|immune system dysfunction]], [[genetics]], changes in the [[gut flora|normal gut bacteria]], and environmental factors.<ref name=NIH2014/><ref name=Hir2015>{{cite journal | vauthors = Akiho H, Yokoyama A, Abe S, Nakazono Y, Murakami M, Otsuka Y, Fukawa K, Esaki M, Niina Y, Ogino H | title = Promising biological therapies for ulcerative colitis: A review of the literature | journal = World Journal of Gastrointestinal Pathophysiology | volume = 6 | issue = 4 | pages = 219–227 | date = November 2015 | pmid = 26600980 | pmc = 4644886 | doi = 10.4291/wjgp.v6.i4.219 | doi-access = free }}</ref> Rates tend to be higher in the developed world with some proposing this to be the result of [[hygiene hypothesis|less exposure to intestinal infections]], or to a [[Western diet]] and lifestyle.<ref name=BMJ2013/><ref name=NEJM2011/> The removal of the appendix at an early age may be protective.<ref name=NEJM2011/> Diagnosis is typically by [[colonoscopy]], a type of [[endoscopy]], with [[tissue biopsies]].<ref name=NIH2014/>

Several medications are used to treat symptoms and bring about and maintain remission, including [[aminosalicylates]] such as [[mesalazine]] or [[sulfasalazine]], [[corticosteroids|steroids]], [[immunosuppressants]] such as [[azathioprine]], and  [[Biological therapy for inflammatory bowel disease|biologic therapy]].<ref name=NIH2014/> [[Colectomy|Removal of the colon by surgery]] may be necessary if the disease is severe, does not respond to treatment, or if complications such as colon cancer develop.<ref name=NIH2014/> [[Proctocolectomy|Removal of the colon and rectum]] generally cures the condition.<ref name=NIH2014/><!-- Quote = Removal of the entire colon, including the rectum, "cures" ulcerative colitis. --><ref name=NEJM2011/>

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