This research report presents a review of literature regarding ulcerative colitis. Areas discussed include the following: definition, epidemiology, etiology, immunology and pathophysiology, clinical presentation, diagnosis, societal impact, therapeutic goals and outcome, prognosis, treatment both non-pharmacological and pharmacological, current drug trials, and future therapies.
Definition, Epidemiology, & Etiology
Ulcerative colitis (UC) is an inflammatory bowel disease (IBD), distinguishable from Chrone's disease (CD), both are the two main types of inflammatory bowel diseases. UC is a chronic condition that includes damage to the gastrointestinal tract and can cause damage to other systems, including skin lesions, joint inflammation, and liver disease (4:57, 5:858).
Causes of UC are not fully understood. It is presumed that pathogenesis may include genetic predisposing factors, biologically internal and external considerations, and modifying elements. Studies with monozygotic twins demonstrate genetically altered mucosal production. Studies also show that children of parents with IBD are at high risk for the disease; early disease presentation is found in those with a family history of IBD (5:858-10).
Other possible predisposing factors for IBD may include deficiencies and abnormalities in the intestinal mucus layer and abnormalities of the mucus glycoproteins. For example, in UC, particular autoantibodies are present. UC patients demonstrate abnormalities in mucus with damaged mucosa, mucus is an essential component of intestinal mucosal defence (5:859-10).
Immunologic mechanisms that may cause or perpetuate intestinal mucosa inflammation are being investigated. For example, the Th3 cell, a T-helper cell, is now introduced as an important concept in bowel inflammation. Th3 cell assists with the regulation of gut tolerance. Genetics regulate types of immune response; UC patients tend to favor a Th2 respons...