Ulcerative colitis

by Jason Wasserman MD PhD FRCPC
March 9, 2022

What is ulcerative colitis?

Ulcerative colitis is a type of inflammatory bowel disease (IBD). It is caused by chronic inflammation (long standing) that damages the colon and prevents it from working normally. The symptoms of this disease include diarrhea, fever, weight loss, bloating, and bloody stools. Pathologists normally describe the features seen in ulcerative colitis as chronic colitis.

How do pathologists make the diagnosis of ulcerative colitis?

If your doctor suspects ulcerative colitis based on your symptoms, they will perform a colonoscopy. A colonoscopy is a procedure where a small camera is used to see the inside of your colon. To determine whether inflammation is present, they will take tissue samples, called biopsies. Because this disease can affect one part of the colon but not another, they will likely take multiple biopsies from the entire length of the colon.

When examined under the microscope, the changes seen in this disease can look very similar to another type of IBD called Crohn’s disease. For this reason, pathologists use the term chronic colitis to describe the features seen in both types of IBD.

Your doctors will use the information in your pathology report along with other information they have collected (e.g. what they saw during the colonoscopy and other symptoms you have reported) before making the final diagnosis.

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