Within a 1-week window, 15 patients with mild to moderately active UC underwent colonoscopy and PET/CT colonography 60 min after injection of 10 mCi of 18F-fluorodeoxyglucose (FDG). We investigated the utility of PET/CT colonography for assessment of extent and activity of UC. Colonoscopy however carries risk during acute exacerbation. 29 Pouchitis (inflammatory disease of the ileal pouchanal anastomosis pouch of unknown etiology) is also common.Extent of involvement and activity of ulcerative colitis (UC) is best evaluated by colonoscopy. Colectomy is associated with a 54 percent reoperation rate for postsurgical complications. 28 Despite the potential benefits of surgery, complications are a concern. 14 A recent systematic literature review showed that 12 months after surgery, health-related quality of life and health status are equivalent to that in the general population. Other indications for surgery are exsanguinating hemorrhage, perforation, or carcinoma. Proctocolectomy with ileal pouch-anal anastomosis is most common however, permanent ileostomy is also an option. 27 For patients with severe acute or chronic colitis who do not improve with medical therapy, surgical proctocolectomy is the next step. Increased risk of infection and lymphoma, infusion reactionĪllergic reactions, bone marrow suppression, infection, pancreatitisĮscherichia coli Nissle 1917 (Mutaflor ¶ oral)įor patients who do not improve with the addition of cyclosporine or infliximab, there is evidence that switching to the other agent may decrease the risk of colectomy however, this is associated with an increased risk of infectious complications, and the decision should be individualized. Headache, † interstitial nephritis, nausea, vomitingĤ0 to 60 mg per day until clinical improvement, then taper by 5 to 10 mg per weekĪdrenal suppression, bone disease, § cataracts, cushingoid features, glaucoma, impaired wound healing, infections, metabolic abnormalities, peptic ulcers, psychiatric disturbances Patients with ulcerative colitis have an increased risk of colon cancer and should have periodic colonoscopy beginning eight to 10 years after diagnosis. If medical management has been ineffective, surgical intervention is indicated for severe disease. Patients with severe or nonresponsive ulcerative colitis should be hospitalized, and intravenous corticosteroids should be given. Infliximab can be added to induce and sustain remission. Corticosteroids may be added if 5-aminosalicylic acid therapy is ineffective. First-line treatment is therapy with 5-aminosalicylic acid. The diagnosis is suspected clinically and confirmed through endoscopic biopsy. Anemia and an elevated erythrocyte sedimentation rate or C-reactive protein level may suggest inflammatory bowel disease, but the absence of laboratory abnormalities does not rule out ulcerative colitis. It is important to exclude infectious etiologies. Ulcerative colitis often presents with abdominal pain, diarrhea, and hematochezia. The incidence peaks in early adulthood, but patients can develop the disorder from early childhood through adulthood. Risk factors include a history of recent infection with Salmonella or Campylobacter, living in Western industrialized nations and at higher latitudes, and a family history of the disease. Ulcerative colitis is a chronic inflammatory disease of the colon.
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