Ulcerative colitis - Revision history

Danbot: Add MedicationDose entry (prednisone) with SMW annotations

2026-03-20T18:48:19Z

Add MedicationDose entry (prednisone) with SMW annotations

← Older revision		Revision as of 18:48, 20 March 2026
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	#**PO: [[Special:MyLanguage/prednisone\|prednisone]] 40mg x 2wks, then decrease by 5mg per week		#**PO: [[Special:MyLanguage/prednisone\|prednisone]] 40mg x 2wks, then decrease by 5mg per week



			==Medication Dosing==
			{{MedicationDose
			\| drug = Prednisone
			\| dose = 40mg daily x 2 weeks, then taper by 5mg/week
			\| route = PO
			\| context = Moderate-severe flare
			\| indication = Ulcerative colitis
			\| population = Adult
			}}

	==Disposition==		==Disposition==

Ostermayer: Prepared the page for translation

2026-01-05T00:01:40Z

Prepared the page for translation

← Older revision		Revision as of 00:01, 5 January 2026
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			<languages/>
			<translate>

	==Background==		==Background==

	[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]		[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]
	*Inflammation tends to be progressively more severe from proximal to distal colon		*Inflammation tends to be progressively more severe from proximal to distal colon
Line 5:		Line 9:
	*Peak incidence occurs in second and third decades of life		*Peak incidence occurs in second and third decades of life

			</translate>
	{{Crohn's vs UC}}		{{Crohn's vs UC}}
			<translate>


	==Clinical Features==		==Clinical Features==
	*[[abdominal pain\|Abdominal cramps]] and [[diarrhea]] (often [[rectal bleeding\|bloody]])
			*[[Special:MyLanguage/abdominal pain\|Abdominal cramps]] and [[Special:MyLanguage/diarrhea\|diarrhea]] (often [[Special:MyLanguage/rectal bleeding\|bloody]])


	===Classification===		===Classification===

	*Mild		*Mild
	**<4 bowel movements per day		**<4 bowel movements per day
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	**Occasional constipation and rectal bleeding		**Occasional constipation and rectal bleeding
	*Moderate		*Moderate
	**[[Colitis]] extends to splenic flexure		**[[Special:MyLanguage/Colitis\|Colitis]] extends to splenic flexure
	*Severe		*Severe
	**Frequent BM		**Frequent BM
	**[[Anemia]]		**[[Special:MyLanguage/Anemia\|Anemia]]
	**[[Fever]]		**[[Special:MyLanguage/Fever\|Fever]]
	**Weight loss		**Weight loss
	**Frequent extraintestinal manifestations		**Frequent extraintestinal manifestations
	**[[colitis\|Pancolitis]]		**[[Special:MyLanguage/colitis\|Pancolitis]]


	==Differential Diagnosis==		==Differential Diagnosis==

			</translate>
	{{Colitis types}}		{{Colitis types}}
			<translate>


	==Evaluation==		==Evaluation==


	===Work-up===		===Work-up===

	*CBC		*CBC
	*Chemistry		*Chemistry
Line 40:		Line 58:
	*Imaging		*Imaging
	**Consider CT based on clinical features and need to rule out more concerning processes		**Consider CT based on clinical features and need to rule out more concerning processes


	===Diagnosis===		===Diagnosis===

	*Positive atypical p-ANCA and negative ASCA is specific for ulcerative colitis		*Positive atypical p-ANCA and negative ASCA is specific for ulcerative colitis


	==Management==		==Management==

	#Rule-out complications:		#Rule-out complications:
	#*[[GI bleed\|Hemorrhage]]		#*[[Special:MyLanguage/GI bleed\|Hemorrhage]]
	#*[[Toxic megacolon]]		#*[[Special:MyLanguage/Toxic megacolon\|Toxic megacolon]]
	#**Develops in advanced disease when all the layers of the colon become involved		#**Develops in advanced disease when all the layers of the colon become involved
	#**Presentation		#**Presentation
	#***Severely ill		#***Severely ill
	#***Abdomen distended, tender, [[peritonitis]]		#***Abdomen distended, tender, [[Special:MyLanguage/peritonitis\|peritonitis]]
	#***[[Fever]], [[tachycardia]]		#***[[Special:MyLanguage/Fever\|Fever]], [[Special:MyLanguage/tachycardia\|tachycardia]]
	#***[[Leukocytosis]] (may be masked if patient taking steroids)		#***[[Special:MyLanguage/Leukocytosis\|Leukocytosis]] (may be masked if patient taking steroids)
	#**Perforation results in high mortality		#**Perforation results in high mortality
	#**[[Abdominal x-ray]]: long, continuous segment of air-filled colon >6cm in diameter		#**[[Special:MyLanguage/Abdominal x-ray\|Abdominal x-ray]]: long, continuous segment of air-filled colon >6cm in diameter
	#*[[anal fistula\|Perirectal fistula]]		#*[[Special:MyLanguage/anal fistula\|Perirectal fistula]]
	#*[[Anorectal abscess\|Perirectal abscess]]		#*[[Special:MyLanguage/Anorectal abscess\|Perirectal abscess]]
	#*Obstruction (due to stricture)		#*Obstruction (due to stricture)
	#*[[colon cancer\|Carcinoma]]		#*[[Special:MyLanguage/colon cancer\|Carcinoma]]
	#[[Steroids]]		#[[Special:MyLanguage/Steroids\|Steroids]]
	#*Parenteral vs PO depending on severity		#*Parenteral vs PO depending on severity
	#**PO: [[prednisone]] 40mg x 2wks, then decrease by 5mg per week		#**PO: [[Special:MyLanguage/prednisone\|prednisone]] 40mg x 2wks, then decrease by 5mg per week


	==Disposition==		==Disposition==

	*Admit for severe complication or severe flare requiring IV steroids		*Admit for severe complication or severe flare requiring IV steroids


	==See Also==		==See Also==
	*[[Colitis]]
			*[[Special:MyLanguage/Colitis\|Colitis]]


	==References==		==References==

	<references/>		<references/>

	[[Category:GI]]		[[Category:GI]]
			</translate>

Rossdonaldson1: /* Background */

2025-09-24T21:01:50Z

Background

← Older revision		Revision as of 21:01, 24 September 2025
Line 1:		Line 1:
	==Background==		==Background==
			[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]
	*Inflammation tends to be progressively more severe from proximal to distal colon		*Inflammation tends to be progressively more severe from proximal to distal colon
	*Rectum is almost always involved		*Rectum is almost always involved

Rossdonaldson1: /* Evaluation */

2022-09-07T17:55:26Z

Evaluation

← Older revision		Revision as of 17:55, 7 September 2022
Line 32:		Line 32:
	*CBC		*CBC
	*Chemistry		*Chemistry
	*ESR/CRP		*LFTs/lipase
			*Consider:
			**ESR/CRP
			**Fecal calprotectin<ref>van Rheenen PF, Van de Vijver E, Fidler V. Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis. BMJ. 2010;15(341):c3369.</ref> (typically requested by GI)
			**Type and screen (if significant bleeding)
			*Imaging
			**Consider CT based on clinical features and need to rule out more concerning processes

			===Diagnosis===
	*Positive atypical p-ANCA and negative ASCA is specific for ulcerative colitis		*Positive atypical p-ANCA and negative ASCA is specific for ulcerative colitis
	*Fecal calprotectin<ref>van Rheenen PF, Van de Vijver E, Fidler V. Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis. BMJ. 2010;15(341):c3369.</ref> (typically requested by GI)
	*Type and screen
	*Imaging
	**Consider CT based on clinical features

	==Management==		==Management==

Kfarzam: /* Work-up */

2022-08-17T03:01:37Z

Work-up

← Older revision		Revision as of 03:01, 17 August 2022
Line 33:		Line 33:
	*Chemistry		*Chemistry
	*ESR/CRP		*ESR/CRP
			*Positive atypical p-ANCA and negative ASCA is specific for ulcerative colitis
	*Fecal calprotectin<ref>van Rheenen PF, Van de Vijver E, Fidler V. Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis. BMJ. 2010;15(341):c3369.</ref> (typically requested by GI)		*Fecal calprotectin<ref>van Rheenen PF, Van de Vijver E, Fidler V. Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis. BMJ. 2010;15(341):c3369.</ref> (typically requested by GI)
	*Type and screen		*Type and screen

Rossdonaldson1: /* Background */

2021-07-07T21:18:26Z

Background

← Older revision		Revision as of 21:18, 7 July 2021
Line 3:		Line 3:
	*Rectum is almost always involved		*Rectum is almost always involved
	*Peak incidence occurs in second and third decades of life		*Peak incidence occurs in second and third decades of life

			{{Crohn's vs UC}}

	==Clinical Features==		==Clinical Features==

Elcatracho: /* Classification */

2021-02-10T15:47:13Z

Classification

← Older revision		Revision as of 15:47, 10 February 2021
Line 21:		Line 21:
	**Weight loss		**Weight loss
	**Frequent extraintestinal manifestations		**Frequent extraintestinal manifestations
	**~~Pan~~[[colitis]]		**[[colitis\|Pancolitis]]

	==Differential Diagnosis==		==Differential Diagnosis==

ClaireLewis: /* Management */

2019-09-30T16:43:35Z

Management

← Older revision		Revision as of 16:43, 30 September 2019
Line 49:		Line 49:
	#**[[Abdominal x-ray]]: long, continuous segment of air-filled colon >6cm in diameter		#**[[Abdominal x-ray]]: long, continuous segment of air-filled colon >6cm in diameter
	#*[[anal fistula\|Perirectal fistula]]		#*[[anal fistula\|Perirectal fistula]]
	#*[[~~perirectal Abscess~~\|Perirectal abscess]]		#*[[Anorectal abscess\|Perirectal abscess]]
	#*Obstruction (due to stricture)		#*Obstruction (due to stricture)
	#*[[colon cancer\|Carcinoma]]		#*[[colon cancer\|Carcinoma]]

ClaireLewis at 16:42, 30 September 2019

2019-09-30T16:42:50Z

← Older revision		Revision as of 16:42, 30 September 2019
Line 5:		Line 5:

	==Clinical Features==		==Clinical Features==
	*Abdominal cramps and diarrhea (often bloody)		*[[abdominal pain\|Abdominal cramps]] and [[diarrhea]] (often [[rectal bleeding\|bloody]])

	===Classification===		===Classification===
Line 11:		Line 11:
	**<4 bowel movements per day		**<4 bowel movements per day
	**No systemic symptoms		**No systemic symptoms
	**Few extraintestinal ~~manifestaions~~		**Few extraintestinal manifestations
	**Occasional constipation and rectal bleeding		**Occasional constipation and rectal bleeding
	*Moderate		*Moderate
	**Colitis extends to splenic flexure		**[[Colitis]] extends to splenic flexure
	*Severe		*Severe
	**Frequent BM		**Frequent BM
	**[[Anemia]]		**[[Anemia]]
	**[[Fever]]		**[[Fever]]
	**Wt loss		**Weight loss
	**Frequent extraintestinal manifestations		**Frequent extraintestinal manifestations
	**~~Pancolitis~~		**Pan[[colitis]]

	==Differential Diagnosis==		==Differential Diagnosis==
Line 38:		Line 38:
	==Management==		==Management==
	#Rule-out complications:		#Rule-out complications:
	#*Hemorrhage		#*[[GI bleed\|Hemorrhage]]
	#*Toxic megacolon		#*[[Toxic megacolon]]
	#**Develops in advanced disease when all the layers of the colon become involved		#**Develops in advanced disease when all the layers of the colon become involved
	#**Presentation		#**Presentation
	#***Severely ill		#***Severely ill
	#***~~Abd~~ distended, tender, peritonitis		#***Abdomen distended, tender, [[peritonitis]]
	#***Fever, tachycardia		#***[[Fever]], [[tachycardia]]
	#***Leukocytosis (may be masked if patient taking steroids)		#***[[Leukocytosis]] (may be masked if patient taking steroids)
	#**Perforation results in high mortality		#**Perforation results in high mortality
	#**~~Abd~~ x-ray: long, continuous segment of air-filled colon >6cm in diameter		#**[[Abdominal x-ray]]: long, continuous segment of air-filled colon >6cm in diameter
	#*Perirectal fistula		#*[[anal fistula\|Perirectal fistula]]
	#*~~Perirectal~~ [[abscess]]		#*[[perirectal Abscess\|Perirectal abscess]]
	#*Obstruction (due to stricture)		#*Obstruction (due to stricture)
	#*Carcinoma		#*[[colon cancer\|Carcinoma]]
	#Steroids		#[[Steroids]]
	#*Parenteral vs PO depending on severity		#*Parenteral vs PO depending on severity
	#**PO: 40mg x 2wks, then decrease by 5mg per week		#**PO: [[prednisone]] 40mg x 2wks, then decrease by 5mg per week

	==Disposition==		==Disposition==

Kearny89: /* Work-up */

2019-06-15T02:15:29Z

Work-up

← Older revision		Revision as of 02:15, 15 June 2019
Line 29:		Line 29:
	===Work-up===		===Work-up===
	*CBC		*CBC
	*Chemistry		*Chemistry
			*ESR/CRP
			*Fecal calprotectin<ref>van Rheenen PF, Van de Vijver E, Fidler V. Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis. BMJ. 2010;15(341):c3369.</ref> (typically requested by GI)
			*Type and screen
	*Imaging		*Imaging
	**Consider CT based on clinical features		**Consider CT based on clinical features