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Ulcerative Colitis Evolve Case Study

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Related Terms:Gastrointestinal Diseases, gastrointestinal disease, ulcerative colitis, 5-aminosalicylate, medication adherence, rectal inflammation, dysplasia surveillance

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Publication of THE LATEST IN ULCERATIVE COLITIS CARE supplement was made possible by an unrestricted educational grant from Aptalis Pharma

Brian Bressler, MD, MS, FRCPC,

CLINICAL TOOLS

Abstract: A 28-year-old male presented to our office for a consultation about his bloody bowel movements. Colonoscopy revealed moderately active left-sided ulcerative colitis extending from the anal verge up to the mid-descending colon. He was prescribed both oral and rectal 5-ASAs for induction therapy, and is in remission. Appropriate patient education has helped him realize that the best chance of staying in remission is to continue on his medical therapy.
Key Words: ulcerative colitis, 5-aminosalicylate, medication adherence, dysplasia surveillance, rectal inflammation.
Stool samples should be tested for infectious causes of bloody diarrhea.
Treatment with steroids should be avoided, if possible, as this medication carries the most risk.
In most cases, clinical remission is an acceptable outcome.
In patients newly diagnosed with left-sided ulcerative colitis, if macroscopic evidence of inflammation stops before 35 cm from the anal verge, it is critical to take biopsies in the proximal left colon in normal-appearing mucosa to determine whether a patient with left-sided disease will require dysplasia surveillance.
Patient education at each follow-up visit helps to ensure medication adherence.
We need to help patients understand that UC can be managed with medication, but not cured.
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Authors' Affiliations

Clinical Assistant Professor of Medicine, Division of Gastroenterology, St. Paul's Hospital, University of British Columbia, Vancouver, BC.

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