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Ulcerative colitis 

Ulcerative colitis
Ulcerative colitis

D.P. Jewell



Aetiology—expanded discussion of genetic associations; mention of recent report incriminating Campylobacter concisus; description of predisposition caused by antibiotic exposure in early life.

Pathology—discussion of CMV colitis in patients with ulcerative colitis.

Treatment—revision of recommendations, including use of anti-TNF monoclonal antibodies and expanded comment on use of thiopurines and of sulphasalazine.

A relevant case history from Oxford Case Histories in Gastroenterology and Hepatology has been added to this chapter.

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date: 28 September 2021

Case History—A 23 yr old woman presenting with a short history of bloody diarrhoea.

Ulcerative colitis is a chronic inflammatory disease of the colon that always affects the rectum, extends proximally to a variable extent, and is characterized by a relapsing and remitting course. In mild disease the mucosa is hyperaemic and granular; punctate ulcers appear in more severe disease, and these may then enlarge and extend deeply. Infiltration with acute and chronic inflammatory cells is largely confined to the mucosa, with histological features of chronicity, e.g. distorted crypt architecture, important in clinical distinction from other causes of colitis, e.g. infective....

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