Ulcerative Colitis

Ulcerative colitis is a lifelong inflammatory disease affecting the rectum and colon to a variable extent that occurs in people with a genetic predisposition following environmental exposures that lead to gut epithelial barrier defects and a dysregulated immune response. Patients usually present with bloody diarrhea, and the diagnosis is based on a combination of clinical, biological, endoscopic, and histological findings. The aim of medical treatment is to induce a rapid clinical response and to maintain clinical and endoscopic remission to prevent long-term disability. Treatments include 5-aminosalicylic acid drugs, thiopurines, biologics (e.g., anti-cytokines and anti-integrins), and small molecules (Janus kinase inhibitors and sphingosine-1-phosphate receptor modulators). Although the therapeutic options are expanding, 10–20% of patients still require proctocolectomy for medically refractory disease.