Prolonged inflammation can lead to damage of the muscularis propria of the colon and perturb neuromuscular function causing colonic dilatation and toxic megacolon.
One of the most feared long-term complications of ulcerative colitis is the development of colorectal carcinoma. Risk of colorectal carcinoma sharply increased 8-10 years after initiation of disease. Therefore, patients typically have close surveillance approximately 8 years after diagnosis.
Ocular complications can occur in some patients with ulcerative colitis including anterior uveitis. The uvea of the eye refers to the vascular middle layer including the iris, ciliary body, and the choroid. Anterior uveitis typically refers to inflammation of the iris and ciliary body.
Pyoderma gangrenosum is characterized by necrotic tissue that causes deep ulcers, typically found on the legs. This skin manifestation is commonly associated with ulcerative colitis.
One extra-intestinal manifestation of ulcerative colitis is the possibility of developing ankylosing spondylitis. Roughly 4-10% of patients with ulcerative colitis can develop ankylosing spondylitis, which is a chronic inflammatory disease involving the axial skeleton
Primary sclerosing cholangitis is characterized by progressive inflammation and scarring of the bile ducts in the liver leading to chronic liver disease. More than 80% of individuals with primary sclerosing cholangitis also have ulcerative colitis. Diagnosis is made by imaging the bile ducts via ERCP which demonstrates a beading pattern caused by strictures and dilations of the bile ducts.
The p-ANCA autoantibody is associated with most cases of ulcerative colitis, and hence reflects an immune response associated with the disease process. This is not specific enough of an antibody, however, to be used as a sole diagnostic measure of ulcerative colitis.
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