Colitis, Ulcerative ; classification ; diagnosis ; pathology ; Humans ; Inflammation ; Medicine, Chinese Traditional

Ulcerative colitis (UC), a kind of chronic nonspecific intestinal inflammation with unknown etiology, is very difficult to cure. It recurs often and even is accompanied with parenteral lesion. It has been rated as one of contemporary refractory diseases by World Health Organization. The author combines the pathological mechanisms of UC with the poison-evil theory and the collateral disease theory, and puts forward that "toxin impairing intestine collateral" pathogenesis theory. We believe that longer accumulation of damp-heat stasis toxin that damages the intestine collateral is the key cause for recurrence and relapses of UC. We explained its theory foundation in terms of pathogenesis of UC from Chinese medicine and modern medicine. The "toxin impairing intestine collateral" theory might perfect the syndrome typing system for UC, and provide a new way of thinking for treating UC.
Colitis, Ulcerative ; diagnosis ; etiology ; pathology ; Humans ; Medicine, Chinese Traditional ; methods

No abstract availble.
Colitis, Ulcerative/complications/*diagnosis/pathology ; Colonoscopy ; Female ; Humans ; Intestinal Obstruction/*diagnosis/etiology/pathology ; Middle Aged

Nowadays, inflammatory bowel disease, such as ulcerative colitis and Crohn's disease, is increasing; however, infectious colitis, such as amebic colitis, is decreasing, so many doctors are not apt to be interested in infectious colitis. In addition, recently amebic colitis has been relatively rare in Korea, and the colonoscopic and the pathologic findings of amebic colitis are very similar to those of other inflammatory bowel diseases. As a consequence, the diagnosis is very difficult if the cyst or the trophozoite of the ameba is not found in the stool examination or in the tissue pathology. The authors experienced three cases in which initial diagnoses of tuberculous colitis, ulcerative colitis, and a simple ulcer were made based on colonoscopic and X-ray findings. However a colonoscopic biopsy revealed a trophozoite form of ameba in the tissue. Hence, a diagnosis of amebic colitis could be made with confidence. Based on these results, we insist that infectious colitis should be included in the differential diagnosis when making a diagnosis of inflammatory bowel disease. In addition, it is extremely important to consider all kinds of infectious colitis, such as amebic colitis.
Amoeba ; Biopsy ; Colitis* ; Colitis, Ulcerative ; Crohn Disease ; Diagnosis ; Diagnosis, Differential ; Dysentery, Amebic* ; Inflammatory Bowel Diseases ; Korea ; Pathology ; Trophozoites ; Ulcer

BACKGROUND/AIMS: Ulcerative colitis is an inflammatory bowel disease with unknown etiology, which has waxed and waned course. It is diagnosed by colon study, pathology, and especially colonoscopy. It is difficult to differentiate between ulcerative colitis and other infectious colitis, especially amebic colitis, and to confirm of remnant lesion by endoscopic findings. METHODS: Magnifying colonoscopy has 100 time magnifying power compared to 30 time of conventional colonoscopy. By spraying 0.2% indigo carmine dye, we evaluated the magnifying and microscopic findings of 31 colonic mucosa of 23 patients with ulcerative colitis. RESULTS: Initial and magnifying chromoscopic findings in ulcerative colitis were loss of cryptal opening 72% (13/18), loss of submucosal vessel 89% (16/18), mucosal denudation (or microscopic erosion) 83% (15/18), and mucosal unevenness 94% (17/18). Recovery rate of magnifying chromoscopic findings after treatment in ulcerative colitis were in crytal opening 80% (8/10), submucosal vascularity 60% (6/10), mucosal denudation (microscopic erosion) 30% (3/10), and in mucosal unevenness 40% (4/10). CONCLUSIONS: It is suggested that magnifying chromoscopic findings in ulcerative colitis may be useful in initial diagnosis and confirmation of remnant lesion, but, not in prediction of clinical severity.
Colitis ; Colitis, Ulcerative* ; Colon ; Colonoscopy ; Diagnosis ; Dysentery, Amebic ; Humans ; Indigo Carmine ; Inflammatory Bowel Diseases ; Mucous Membrane ; Pathology ; Ulcer*

Ulcerative colitis (UC) is a chronic, non-specific intestinal disease that not only affects the quality of life of patients and their families but also increases the risk of colorectal cancer. The nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing protein 3 (NLRP3) inflammasome is an important component of inflammatory response system, and its activation induces an inflammatory cascade response that is involved in the development and progression of UC by releasing inflammatory cytokines, damaging intestinal epithelial cells, and disrupting the intestinal mucosal barrier. Chinese medicine (CM) plays a vital role in the prevention and treatment of UC and is able to regulate NLRP3 inflammasome. Many experimental studies on the regulation of NLRP3 inflammasome mediated by CM have been carried out, demonstrating that CM formulae with main effects of clearing heat, detoxifying toxicity, drying dampness, and activating blood circulation. Flavonoids and phenylpropanoids can effectively regulate NLRP3 inflammasome. Other active components of CM can interfere with the process of NLRP3 inflammasome assembly and activation, leading to a reduction in inflammation and UC symptoms. However, the reports are relatively scattered and lack systematic reviews. This paper reviews the latest findings regarding the NLRP3 inflammasome activation-related pathways associated with UC and the potential of CM in treating UC through modulation of NLRP3 inflammasome. The purpose of this review is to explore the possible pathological mechanisms of UC and suggest new directions for development of therapeutic tools.
Humans ; Inflammasomes/metabolism* ; Colitis, Ulcerative/pathology* ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Medicine, Chinese Traditional ; Quality of Life ; Colitis

Colonoscopic evaluation has revolutionized the management of colorectal disorders, of which colorectal neoplasia is the most important. Experience with 2000 consecutive colonoscopies was reviewed to determine their clinical significance. The symptoms that patients complained about were anal bleeding, abdominal pain, diarrhea, and constipation. Colonic polyps, colon cancer, and ulcerative colitis were diagnosed by colonoscopy. Colonic polyps were the most common pathology for anal bleeding and constipation. Ulcerative colitis was the most common pathology for diarrhea. Intestinal tuberculosis was the most common pathology for abdominal pain. Colon cancer was the most common pathology for tenesmus. Lymphoid hyperplasia was the most common pathology in patients under 10. Ulcerative colitis was the most common pathology in patients in their 3rd or 4th decade. Colonic polyp was the most common pathology in patients in their 5th, 6th, or 7th decade. Colon cancer was the most common pathology in patients in their of 8th or 9th decade. A colonoscopic polypectomy was performed in 49.5% of the colonoscopies, and an open polypectomy was done in 2.7%. There were no surgical complications from the colonoscopies. As a result of this study, it is concluded that total colonoscopic examination should be performed in patients over 40 who complain about rectal bleeding and tenesmus. To avoid complications and give proper management, it is recommended that colonoscopy be performed by a surgeon.
Abdominal Pain ; Colitis, Ulcerative ; Colonic Neoplasms ; Colonic Polyps ; Colonoscopy ; Constipation ; Diarrhea ; Hemorrhage ; Humans ; Hyperplasia ; Pathology ; Tuberculosis

Adolescent ; Child ; Child, Preschool ; Colitis, Ulcerative ; pathology ; Colonoscopy ; Female ; Humans ; Infant ; Male

Liver abscesses are very rare complications of ulcerative colitis, and furthermore, there has been only one case of splenic abscess in a patient with ulcerative colitis reported in the English literature. We recently encountered a patient with ulcerative colitis accompanied by both hepatic and splenic abscesses. The patient was treated with abscess drainage as well as sulfasalazine and antibiotics. Follow-up sonography of the abdomen showed complete resolution of the lesions. To our knowledge, this is the first report of combined case of multiple liver abscesses combined with splenic abscess in a patient with ulcerative colitis.
Abdominal Abscess/complications/*pathology ; Adolescent ; Colitis, Ulcerative/complications/*pathology ; Female ; Humans ; Liver Abscess/complications/*pathology ; Splenic Diseases/complications/*pathology

Ulcerative colitis is a non-specific colorectal inflammation of unknown causes. It is now known to complicate the dangers of colorectal cancer more than was previously thought. Macrophages are an important part of immune system and play a positive role in immune reaction. But it has been shown that the phenotype and the function of macrophages change in the tumor microenvironment. Through their interaction with colorectal cancer cells and by releasing large quantities of cytokines, macrophages promote colorectal cancer cells by inhibiting angiogenesis and inhibit apoptosis. But the macrophages are also affected by cancer, interact with other inflammatory cells, and become immune suppressed. Thus the changes of macrophages are inseparable with colitis-associated colorectal carcinogenesis.
Carcinogenesis ; Cell Transformation, Neoplastic ; immunology ; Colitis, Ulcerative ; complications ; immunology ; pathology ; Colorectal Neoplasms ; etiology ; immunology ; pathology ; Disease Progression ; Humans ; Macrophages ; pathology