gastrointestinal disorders
Ulcerative Colitis
Symptoms and Signs of Ulcerative Colitis
Patients typically have Attacks of bloody diarrhea of varied intensity and duration interspersed with asymptomatic intervals Usually an attack begins insidiously, with increased urgency to defecate, mild lower abdominal cramps, and blood and mucus in the stools. Some cases develop after an infection (eg, amebiasis, bacillary dysentery). When ulceration is confined to the rectosigmoid, the stool may be normal or hard and dry, but rectal discharges of mucus loaded with red and white blood cells accompany or occur between bowel movements. Systemic symptoms are absent or mild. If ulceration extends proximally, stools become looser and the patient may have>10 bowel movements per day, often with severe cramps and distressing rectal tenesmus, without respite at night. The stools may be watery or contain mucus and frequently consist almost entirely of blood and pus. Toxic or fulminant colitis manifests initially with sudden violent diarrhea, fever to 40°C (104°F), abdominal pain, signs of peritonitis (eg, rebound tenderness), and profound toxemia. Systemic symptoms and signs, more common with extensive ulcerative colitis, include malaise, fever, anemia, anorexia, and weight loss. Extraintestinal Manifestations (IBD), particularly joint and skin complications, are most common when systemic symptoms are present. 