#inflammatory #bowel #disease



A 45-year-old man presented with difficult #defecation, abdominal #colic, and sometimes #diarrhea underwent #colonoscopy. The scope revealed #ulcerated mucosa with debris, #bleeding, and whitish mucosa (picture of #ulcerative_ colitis). The whole colon is affected apart from the ascending colon and the right half of the transverse colon. Colonic #biopsies were taken for #histopathology. The patient gives a history of a previously operated anal abscess. QUESTIONS: 1- how do you calculate the score of ulcerative colitis, and what scoring system do you use? 2- in these cases, do you take biopsies from healthy and unhealthy mucosa or the sick only, and why? 3- as you noticed from the video, the anorectal region is affected. Do you prefer a particular type of treatment, and is ulcerative colitis the cause of difficult defecation or the previous operation? 4- Some OF the patient symptoms are more common in patients with Crohn's disease than ulcerative colitis. Mention them?

Comments

Anonymous said…
Biopsies should be taken both from the terminal ileum and colon including unaffected areas. Difficulty in defecation could be due to the colitis. I personally use the Mayo score and my calculation is score 1-2 (mild disease). As for the initial treatment pending the histology results and C. Dificille workup and other pathogens should be antibiotics as long as the patient's status remains stable