Pathologic, endoscopic, and radiologic examinations are particularly important for diagnosis. Endoscopy is a general term for procedures that look inside the gastrointestinal tract. During endoscopy, tiny tissue samples may be taken for biopsy. Colonoscopy examines the entire colon to determine the extent of disease and to distinguish between ulcerative colitis and Crohn's disease. By examining bowel tissue, cells, and fluid specimens under the microscope, a pathologist who specializes in gastrointestinal pathology provides vital input for treatement decisions and is a valuable member of the treatment team.
Ulcerative colitis affects only the large intestine.
It does not affect the esophagus, stomach, or small intestine. The inflammation begins in the rectum and then spreads to other segments of the colon. Patients with ulcerative colitis usually have non-bloody diarrhea that subsequently becomes bloody. Most patients have mild symptoms that progress slowly, but occasionally the symptoms can be very dramatic with severe bloody diarrhea, abdominal pain, and fever. Ulcerative colitis runs a chronic course characterized by alternating periods of activity and inactivity.