Like Crohn's disease, ulcerative colitis is a chronic inflammatory condition of the bowel which often first occurs in childhood and young adulthood. Unlike Crohn's disease, ulcerative colitis only involves the colon, and typically is most severe in the rectum and less severe higher up in the large intestine. It is also a continuous inflammation, without normal areas of mucosa interspersed amid the disease. The majority of patients, however, will have periods of remission and relapse over the years. Extraintestinal manifestations most often involve inflammation in joints, skin, bile ducts, and the eye.
Diagnosis is made by colonoscopy with mucosal biopsies.
Mild cases of ulcerative colitis, when localized only to the rectum, are referred to as proctitis and may be managed with administration of anti-inflammatory medicine in the form of an enema. More severe cases require oral anti-inflammatory or immunosuppressant therapy. The disease can be cured by removing the colon in cases not responsive to medical therapy. Chronic ulcerative colitis is a risk factor for colon cancer, with the risk directly proportional to the duration and extent of the disease. Surveillance colonscopies at regular intervals are therefore recommended for patients with ulcerative colitis for greater than 7 years and with disease which extends up to and above the splenic flexure.