| Theme |
The Newest Strategies for Severe Ulcerative Colitis |
| Title |
Extraintestinal Complications in Ulcerative Colitis |
| Author |
Nobuo Hiwatashi |
Colorectal Center, Sendai Red Cross Hospital |
| Author |
Yoshitaka Kinouchi |
Department of Gastroenterology, Tohoku University Graduate School of Medicine |
| Author |
Sei-ichi Takahashi |
Department of Gastroenterology, Tohoku University Graduate School of Medicine |
| Author |
Tooru Shimosegawa |
Department of Gastroenterology, Tohoku University Graduate School of Medicine |
| [ Summary ] |
Many patients with ulcerative colitis, especially the more severe and more extensive forms, have extraintestinal complications. Pathogenesis of these systemic manifestations can be classified either by metabolic or physiological mechanisms, which are due to colonic inflammation or by immunological distur bances. Most complications associated with abnormal immunological reactions, colitic arthropathy, erythema nodosum, uveitis/iritis etc. are related to the activity of colitis, and show improvement with steroid therapy or colectomy. Patients with active lesions develop a hypercoagulation state, and this condition leads to vascular complications such as strokes, pulmonary emboli, thrombophlebitis, or thromboemboli. Primary sclerosing cholamgitis(PSC) and ankylosing spondylitis should not be expected to improve with medical therapy or colectomy. These disorders progress relentlessly. For progressive PSC, liver transplantation should to be considered. |