Ulcerative colitis physical examination: Difference between revisions

Jump to navigation Jump to search
m (Bot: Removing from Primary care)
 
(13 intermediate revisions by 2 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Ulcerative colitis}}
{{Ulcerative colitis}}
{{CMG}}
{{CMG}}; {{AE}} {{USAMA}}
 
==Overview==
Ulcerative colitis shows intestinal and extra intestinal findings on physical examination. These include abdominal tenderness, [[fever]], [[pallor]], inflammation of the iris and uvea, skin rash, inflammation of the joints, aphthous ulcers and clubbing of the fingers.<ref name="pmid8596552">{{cite journal| author=Hanauer SB| title=Inflammatory bowel disease. | journal=N Engl J Med | year= 1996 | volume= 334 | issue= 13 | pages= 841-8 | pmid=8596552 | doi=10.1056/NEJM199603283341307 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8596552  }} </ref><ref name="pmid3356884">{{cite journal| author=Prantera C, Davoli M, Lorenzetti R, Pallone F, Marcheggiano A, Iannoni C et al.| title=Clinical and laboratory indicators of extent of ulcerative colitis. Serum C-reactive protein helps the most. | journal=J Clin Gastroenterol | year= 1988 | volume= 10 | issue= 1 | pages= 41-5 | pmid=3356884 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3356884  }} </ref>


== Physical Examination ==
== Physical Examination ==
As ulcerative colitis is a [[systemic]] disease, patients may present with [[symptom]]s and [[complication (medicine)|complications]] outside the colon.  These include the following:<ref name="pmid8596552">{{cite journal| author=Hanauer SB| title=Inflammatory bowel disease. | journal=N Engl J Med | year= 1996 | volume= 334 | issue= 13 | pages= 841-8 | pmid=8596552 | doi=10.1056/NEJM199603283341307 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8596552  }} </ref>
As ulcerative colitis is a [[systemic]] disease, patients may present with [[symptom]]s and [[complication (medicine)|complications]] outside the colon.  These include the following:<ref name="pmid8596552">{{cite journal| author=Hanauer SB| title=Inflammatory bowel disease. | journal=N Engl J Med | year= 1996 | volume= 334 | issue= 13 | pages= 841-8 | pmid=8596552 | doi=10.1056/NEJM199603283341307 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8596552  }} </ref><ref name="pmid9260788">{{cite journal| author=D'Haens G, Geboes K, Peeters M, Baert F, Ectors N, Rutgeerts P| title=Patchy cecal inflammation associated with distal ulcerative colitis: a prospective endoscopic study. | journal=Am J Gastroenterol | year= 1997 | volume= 92 | issue= 8 | pages= 1275-9 | pmid=9260788 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9260788  }} </ref><ref name="pmid10566726">{{cite journal| author=Kim B, Barnett JL, Kleer CG, Appelman HD| title=Endoscopic and histological patchiness in treated ulcerative colitis. | journal=Am J Gastroenterol | year= 1999 | volume= 94 | issue= 11 | pages= 3258-62 | pmid=10566726 | doi=10.1111/j.1572-0241.1999.01533.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10566726  }} </ref><ref name="pmid16151544">{{cite journal| author=Silverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR et al.| title=Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. | journal=Can J Gastroenterol | year= 2005 | volume= 19 Suppl A | issue=  | pages= 5A-36A | pmid=16151544 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16151544  }} </ref><ref name="pmid28420941">{{cite journal| author=Guan Q, Zhang J| title=Recent Advances: The Imbalance of Cytokines in the Pathogenesis of Inflammatory Bowel Disease. | journal=Mediators Inflamm | year= 2017 | volume= 2017 | issue=  | pages= 4810258 | pmid=28420941 | doi=10.1155/2017/4810258 | pmc=5379128 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28420941  }} </ref>
 
===General appearance===
*Normal appearance in mild disease
*[[Pallor]] may be noticed
 
===Vital signs===
*[[Fever]]
*[[Tachycardia]]
*[[Hypotension]]


===Gastrointestinal===
*Normal in mild disease
*[[Abdominal]] [[tenderness ]]when palpated in severe disease
*Blood seen on rectal exam


===Eyes===
===Eyes===
* Ophthalmic (involving the eyes):
The ophthalmic physical exam findings may include:
** [[Iritis]] or [[uveitis]], which is inflammation of the iris
* [[Iritis]] or [[uveitis]], which is inflammation of the iris
** Episcleritis
* [[Episcleritis]]


===Musculoskeletal===
===Musculoskeletal===
* Musculoskeletal:
 
** Seronegative [[arthritis]], which can be a large-joint [[arthritis|oligoarthritis]] (affecting one or two joints), or may affect many small joints of the hands and feet
* Seronegative [[arthritis]], which can be a large-joint [[arthritis|oligoarthritis]] (affecting one or two joints), or may affect many small joints of the hands and feet
** [[Ankylosing spondylitis]], arthritis of the spine
* [[Ankylosing spondylitis]], arthritis of the spine
** [[Sacroiliitis]], arthritis of the lower spine
* [[Sacroiliitis]], arthritis of the lower spine


===Skin===
===Skin===
* Cutaneous (related to the skin):
 
** [[Erythema nodosum]], which is a [[panniculitis]], or inflammation of subcutaneous tissue involving the lower extremities
* [[Erythema nodosum]], which is a [[panniculitis]], or inflammation of subcutaneous tissue involving the lower extremities
** [[Pyoderma gangrenosum]], which is a painful ulcerating lesion involving the [[skin]]
* [[Pyoderma gangrenosum]], which is a painful ulcerating lesion involving the [[skin]]


===Other===
===Other===
Line 32: Line 48:
<div align="center">
<div align="center">
<gallery heights="175" widths="175">
<gallery heights="175" widths="175">
Image:Canker sore.jpg|Patients with '''ulcerative colitis''' can occasionally have [[mouth ulcer|Aphthous ulcers]] involving the [[tongue]], [[lips]], [[palate]] and [[pharynx]]
Image:Canker sore.jpg|Patients with '''ulcerative colitis''' can occasionally have [[mouth ulcer|Aphthous ulcers]] involving the [[tongue]], [[lips]], [[palate]] and [[pharynx]]|thumb|By Photographer: User:TheBlunderbuss - Own work. Published under GFDL in English Wiki, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=591677
</gallery>
</gallery>
</div>
</div>
Line 38: Line 54:
== References ==
== References ==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Primary care]]
[[Category:Autoimmune diseases]]
[[Category:Autoimmune diseases]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
Line 47: Line 63:
[[Category:Abdominal pain]]
[[Category:Abdominal pain]]
[[Category:Needs overview]]
[[Category:Needs overview]]
{{WH}}
{{WS}}

Latest revision as of 00:33, 30 July 2020

Ulcerative colitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Ulcerative colitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Abdominal X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Alternative Treatments

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Ulcerative colitis physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Ulcerative colitis physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Ulcerative colitis physical examination

CDC on Ulcerative colitis physical examination

Ulcerative colitis physical examination in the news

Blogs on Ulcerative colitis physical examination

Directions to Hospitals Treating Ulcerative colitis

Risk calculators and risk factors for Ulcerative colitis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Ulcerative colitis shows intestinal and extra intestinal findings on physical examination. These include abdominal tenderness, fever, pallor, inflammation of the iris and uvea, skin rash, inflammation of the joints, aphthous ulcers and clubbing of the fingers.[1][2]

Physical Examination

As ulcerative colitis is a systemic disease, patients may present with symptoms and complications outside the colon. These include the following:[1][3][4][5][6]

General appearance

  • Normal appearance in mild disease
  • Pallor may be noticed

Vital signs

Gastrointestinal

Eyes

The ophthalmic physical exam findings may include:

Musculoskeletal

Skin

Other

References

  1. 1.0 1.1 Hanauer SB (1996). "Inflammatory bowel disease". N Engl J Med. 334 (13): 841–8. doi:10.1056/NEJM199603283341307. PMID 8596552.
  2. Prantera C, Davoli M, Lorenzetti R, Pallone F, Marcheggiano A, Iannoni C; et al. (1988). "Clinical and laboratory indicators of extent of ulcerative colitis. Serum C-reactive protein helps the most". J Clin Gastroenterol. 10 (1): 41–5. PMID 3356884.
  3. D'Haens G, Geboes K, Peeters M, Baert F, Ectors N, Rutgeerts P (1997). "Patchy cecal inflammation associated with distal ulcerative colitis: a prospective endoscopic study". Am J Gastroenterol. 92 (8): 1275–9. PMID 9260788.
  4. Kim B, Barnett JL, Kleer CG, Appelman HD (1999). "Endoscopic and histological patchiness in treated ulcerative colitis". Am J Gastroenterol. 94 (11): 3258–62. doi:10.1111/j.1572-0241.1999.01533.x. PMID 10566726.
  5. Silverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR; et al. (2005). "Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology". Can J Gastroenterol. 19 Suppl A: 5A–36A. PMID 16151544.
  6. Guan Q, Zhang J (2017). "Recent Advances: The Imbalance of Cytokines in the Pathogenesis of Inflammatory Bowel Disease". Mediators Inflamm. 2017: 4810258. doi:10.1155/2017/4810258. PMC 5379128. PMID 28420941.

Template:WH Template:WS