Defined as chronic, recurrent and progressive GIT mucosal inflammation (autoimmune); commonly as proctitis, proctosigmoiditis, Left-sided colitis, and Extensive colitis.
Only mucosal, with the formation of crypt abscesses and reduction in goblet cell mucin. In severe cases, the submucosa or deeper muscular layers can be affected.
induce remission; endoscopic and clinical remission.
Defining UC severity is a key factor in management:
|Mild; common||Moderate 27%||Sever < 1%|
|≤4 stools per day +/- little blood.||≤6 stools per day + hematochezia+ anime Hb> 10g/dL.||>6 bloody stools per day + anime Hb< 10g/dL.|
|No signs of systemic toxicity (eg, no tachycardia)||Minimal systemic manifestations; low-grade fever.||Systemic toxicity; fever > 37.5 C, tachycardia .|
|Normal CRP & ESR||Normal CRP & ESR||High CRP, ESR, fecal calprotectin & Low Albumin.|
|Mild abdominal pain, tenesmus, or constipation.||Moderate abdominal pain, tenesmus, or constipation.||Sever abdominal pain, Weight loss, extraintestinal complications|
|No response to mild-moderate regimen.|
|History of hospitalization|
|Endoscope: extensive colitis w/ deep ulcerations.|
How to use levels:
Level 1-2 is to treat mild to moderate extensive colitis.
To treat moderate to severe extensive colitis, Use level 4-5 of proctitis management plan.