Review Current Status and Advances in Diagnosis and Treatment of Ulcerative Colitis
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摘要
Ulcerative colitis (UC) is a chronic disease characterized by diffuse mucosal inflammation limited to the colon. It involves rectum in-about 95％ of cases and may extend proximally in a symmetrical,circumferential and uninterrupted pattern to involve parts or all of large intestine[1]. The disease is more common in Caucasians than in Blacks or Orientals with an increased incidence (three to six fold) in Jews[2,3]. In US, the disease accounts for a quarter million physician visits annually, 20,000 hospitalizations and loss of over a million work-loss days per year[4]. In China, number of UC patients have increased significantly in the past 10 years[5]. The incidence of UC varies greatly in different geographical areas of the world[6]. Ulcerative colitis was first described by Sir Samuel Wilks in 1859[7]. The first case reported in China was in 1956[8]. The etiology of UC is still not clear. UC is a non-specific chronic inflammation involving mucosa and sub mueosa. The hallmark clinical symptom is bloody diarrhea often with symptoms of rectal urgency and tenesmus [9]. The clinical course is marked by exacerbations and remissions which may occur spontaneously or in response to intereurrent illness [10]. Colonoscopy or Proctosigmoidoseopy and biopsy are the test of choice to diagnose ulcerative colitis. Characteristic changes include loss of of typical vascular pattern, friability, exudates, ulceration and granularity in a continuous, circumferential pattern [11] as seen in figures 1-6.Medications used in treating ulcerative colitis include anti inflammatory agents such as 5-ASA, systemic and topical corticosteroids and immunomodulators[12].
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