DANIEL PRESENT, MD: The main types that we classify are, first, proctitis. And that involves just the rectum, which is about anywhere from five to seven inches. And those patients, they can have bleeding and urgency, but they don't get sick systemically. We then talk about proctosigmoiditis, where it involves the sigmoid and that's pretty close to proctitis, similar type symptoms, perhaps a little bit more severe, a little bit more discomfort. Then, we classify it as left-sided colitis, where it goes from the rectum up to the splenic flexure with no skip areas. And, finally, we classify it as extensive or universal disease where the whole colon is involved. These are the patients, in the short term, that are at risk for being sicker, for developing more severe disease, and unfortunately with these patients, eight to ten years later if they've had extensive disease, there is now suddenly an increased risk for developing colorectal cancer.
Fulminant disease is usually associated with extensive disease, occasionally left-sided. But, in this situation, the patient is systemically sick. They're usually running fevers, they've lost a lot of weight, their bellies are very tender and they are at high risk for complications such as perforation or the development of something called toxic megacolon.
ANNOUNCER: Diagnosing ulcerative colitis can be complicated and takes many factors into consideration.
DAVID RUBIN, MD: The diagnosis is made by a combination of a variety of important things, starting with a patient who has symptoms of an inflamed rectum, usually with blood in their stool, and supported further by laboratory tests, which are blood tests, and it is very important that the patient have some type of endoscopy, usually a colonoscopy, where biopsies are obtained and looked at by an experienced pathologist.
ANNOUNCER: Ulcerative colitis is a chronic disease that requires ongoing treatment. Serious complications can occur including an increased risk for colorectal cancer. Although there is no known cure for the disease, therapies are available that may significantly reduce the signs and symptoms and even bring about long-term remission.
STEPHEN HANAUER, MD: We’ve known about ulcerative colitis for well more than 100 years. The vast majority of patients can be treated successfully and can expect to have normal lifestyle and live a normal life expectancy.
