page_title: Ulcerative colitis
section_title: Extraintestinal features
hierarchical_section_title: Ulcerative colitis / Signs and symptoms / Extraintestinal features
caption_attribution_description: Čeština: Aftózní stomatitida English: Aphtha
context_page_description: Ulcerative colitis is a long-term condition that results in inflammation and ulcers of the colon and rectum. The primary symptoms of active disease are abdominal pain and diarrhea mixed with blood. Weight loss, fever, and anemia may also occur. Often, symptoms come on slowly and can range from mild to severe. Symptoms typically occur intermittently with periods of no symptoms between flares. Complications may include megacolon, inflammation of the eye, joints, or liver, and colon cancer.
  The cause of UC is unknown. Theories involve immune system dysfunction, genetics, changes in the normal gut bacteria, and environmental factors. Rates tend to be higher in the developed world with some proposing this to be the result of less exposure to intestinal infections, or to a Western diet and lifestyle. The removal of the appendix at an early age may be protective. Diagnosis is typically by colonoscopy with tissue biopsies. It is a kind of inflammatory bowel disease along with Crohn's disease and microscopic colitis.
  Dietary changes, such as maintaining a high-calorie diet or lactose-free diet, may improve symptoms.
context_section_description: As UC is believed to have a systemic (i.e., autoimmune) origin, people with UC may present with comorbidities leading to symptoms and complications outside the colon. The frequency of such extraintestinal manifestations has been reported as between 6 and 47%, and include:
  Aphthous ulcers may develop in the mouth. Inflammation may occur in the interior portion of the eye, leading to uveitis and iritis. Uveitis can cause blurred vision and eye pain, especially when exposed to light (photophobia). Untreated, uveitis can lead to permanent vision loss. Inflammation may also involve the white part of the eye (sclera) or the overlying connective tissue (episclera), causing conditions called scleritis and episcleritis, respectively.
  UC may cause several joint manifestations, including a type of rheumatologic disease known as Seronegative arthritis, which may affect few large-joints (oligoarthritis), the vertebra (ankylosing spondylitis) or several small joints of the hands and feet (peripheral arthritis). Often the insertion site where muscle attaches to bone (entheses) becomes inflamed (enthesitis). Inlammation may affect the sacroiliac joint (sacroiliitis). The symptoms of arthritis include painful, warm, swollen, stiff joints, and loss of joint mobility or function.
  Ulcerative colitis may affect the skin, blood, and endocrine system. The most common type of skin manifestation, erythema nodosum, presents as raised, tender red nodules usually appearing on the shins. Erythema nodosum is due to inflammation of the underlying subcutaneous tissue (panniculitis). A more severe skin manifestation, pyoderma gangrenosum, is characterized painful pustules or nodules that become ulcers which progressively grow. UC increases the risk of blood clots; painful swelling of the lower legs can be a sign of deep venous thrombosis, while difficulty breathing may be a result of pulmonary embolism (blood clots in the lungs). The immune system may attack the red blood cells, leading to autoimmune hemolytic anemia. In addition to autoimmune destruction, anemia may occur due to chronic blood loss from rectal bleeding and bone marrow suppression due to inflammation (anemia of chronic disease). Osteoporosis may occur related to systemic inflammation, which increases the risk of bone fractures. Clubbing, a deformity of the ends of the fingers, and hypertrophic osteoarthropathy may occur.
caption: Aphthous ulcers involving the tongue, lips, palate, and pharynx.
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