Ulcerative colitis

Infl ammatory bowel disease encompasses a spectrum between ulcerative colitis and Crohn disease. Ulcerative colitis is manifest by diffuse, continuous, and superfi cial infl ammation that begins in the rectum and extends proximally to a variable extent in individual patients. In approximately 15% of patients with infl ammatory bowel disease confi ned to the colon the pattern of infl ammation is not distinguishable, necessitating the term indeterminate colitis or IBD - U (unclassifi ed). Features that are helpful to discriminate between ulcerative colitis and Crohn disease include: Family history, smoking history, presence of perianal manifestations, aphthous ulcerations, strictures, and fi stulae. Therapeutic approaches are aimed at induction and maintenance of clinical remissions. Inductive agents include aminosalicylates, corticosteroids, cyclosporine, and monoclonal antibodies targeting tumor necrosis factor (TNF). Maintenance therapies include aminosalicylates, thiopurines, or anti - TNF agents. Colectomy is an option for refractory disease.