The incidence of ulcerative colitis in North America is 10–12 cases per 100,000 per year, with a peak incidence of ulcerative colitis occurring between the ages of 15 and 25. There is thought to be a bimodal distribution in age of onset, with a second peak in incidence occurring in the 6th decade of life. The disease affects females more than males. with highest incidences in the United States, Canada, the United Kingdom, and Scandinavia. Higher incidences are seen in northern locations compared to southern locations in Europe and the United States.
As with Crohn's disease, the prevalence of ulcerative colitis is greater among Ashkenazi Jews and decreases progressively in other persons of Jewish descent, non-Jewish Caucasians, Africans, Hispanics, and Asians. of ulcerative colitis depends on the extent of the disease process. Patients usually present with diarrhea mixed with blood and mucus, of gradual onset. They also may have signs of weight loss, and blood on rectal examination. The disease is usually accompanied with different degrees of abdominal pain, from mild discomfort to severely painful cramps.
Ulcerative colitis is associated with a general inflammatory process that affects many parts of the body. Sometimes these associated extra-intestinal symptoms are the initial signs of the disease, such as painful, arthritic knees in a teenager. The presence of the disease cannot be confirmed, however, until the onset of intestinal manifestations.
Extent of involvement
Ulcerative colitis is normally continuous from the rectum up the colon. The disease is classified by the extent of involvement, depending on how far up the colon the disease extends:
- ''Distal colitis'', potentially treatable with enemas:
|
| Distribution of Disease
| Patchy areas of inflammation
| Continuous area of inflammation
|
| Endoscopy
| Linear and serpiginous (snake-like) ulcers
| Continuous ulcer
|
| Depth of inflammation
| May be transmural, deep into tissues
| Shallow, mucosal
|
| Fistulae, abnormal passageways between organs
| Commonly
| Seldom
|
| Biopsy | Can have granulomata
| Crypt abscesses and cryptitis
|
| Surgical cure?
| Often returns following removal of affected part
| Usually cured by removal of colon, can be followed by pouchitis
|
| Smoking
| Higher risk for smokers
| Lower risk for smokers
|
| Autoimmune disease?
| Generally regarded as an autoimmune disease
| No consensus
|
| Cancer risk?
| Lower than ulcerative colitis
| Higher than Crohn's
Further Reading
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"Ulcerative colitis"
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