Diagnosis of Ulcerative Colitis

Abstract

New descriptions or additions regarding the definitions of gastroduodenal lesions, postoperative pouchitis, indeterminate colitis, and refractory cases (1. steroid-resistant cases, 2. steroid-dependent cases, 3. cases resistant to treatment other than steroid treatment) were made in the 2010 revision of the diagnostic criteria for ulcerative colitis (draft) based on changes in treatment policy or new findings related to diagnosis in recent years. Because the treatment of ulcerative colitis is primarily medical therapy depending on the extent of the lesions and disease severity, it is very important to make an accurate diagnosis and identify the pathology soon after the onset of symptoms. Indicators for evaluating activity, including clinical indicators and endoscopic indicators, exist in order to objectively evaluate the pathology, but it is necessary to understand the special characteristics of each of them and to apply them to treatment. In addition, ulcerative colitis has been defined as diffuse nonspecific inflammation of the large bowel of unknown etiology, but upper gastrointestinal tract and small bowel lesions associated with ulcerative colitis that do not seem to fit this disease concept have been reported in recent years, and they may hold clues to the elucidation of its etiology.