Clinical Features

• Bloody diarrhea with mucus

• Fecal urgency

• Abdominal pain and cramps

• Tenesmus

• General: fatigue, fever

• Skeletal (most common extraintestinal manifestation of ulcerative colitis): osteoarthritis, ankylosing spondylitis, sacroiliitis

• Ocular: uveitis, episcleritis, iritis

• Biliary: primary sclerosing cholangitis (it is rare for patients with ulcerative colitis to develop PSC, but up to 90% of all patients with PSC will also have ulcerative colitis)

• Cutaneous

  • Erythema nodosum

  • Pyoderma gangrenosum

  • Aphthous stomatitis

  • Pyostomatitis vegetans

    • A very rare condition that is associated with other cutaneous diseases and inflammatory bowel disease, particularly ulcerative colitis

    • Manifests with multiple aphthae and pustules of the oral mucosa

• In children and adolescents: growth retardation and delayed puberty

PSC is often associated with inflammatory bowel disease, especially ulcerative colitis. However, only approximately 4% of patients with inflammatory bowel disease develop PSC.

“ULCCCERS:” Ulcers, Large intestine, Continuous/Colon cancer/Crypt abscesses, Extends proximally, Red diarrhea, and Sclerosing cholangitis are the characteristics of ulcerative colitis.

• Chronic intermittent

  • Most common course

  • Exacerbation is followed by complete remission.

• Chronic continuous

  • Complete remission does not occur.

  • Disease severity varies.

• Acute fulminant

  • Sudden onset

  • Severe diarrhea, dehydration, shock