Clinical Manifestation of Ulcerative Colitis
The first manifestation of ulcerative colitis varies, and bloody diarrhea is the most common early symptom. There are other symptoms of ulcerative colitis, such as abdominal pain, hematochezia, loss of weight, tenesmus and emesis. Occasionally the symptoms can be arthritis, iridocyclitis, hepatosis and skin lesion, while fever is relatively uncommon. For most patients, the symptoms of ulcerative colitis are chronic, low-grade of malignancy, while for a few patients (about 15%) the symptoms are acute and catastrophic. For these patients, the main symptoms are multiple bloody defecations, sometimes even 30 times per day, along with fever and abdominal pain.
Physical signs are directly related with duration of illness and clinical manifestation. Patients often lose weight and look pale, haphalgesia always occur when touching the colon area in active stage of illness. There are possible acute abdominal disease symptoms along with fever and decrease of borborygmus, especially in acute attack or fulminate cases. There might be abdominal distension, fever and acute abdominal disease symptoms when toxic megacolon occurs. Due to the frequent diarrhea, the crissum skin might be scratched or denuded, so is crissum inflammation such as anal fissure or anal fistula, and the fistula is more commonly seen in Crohn disease. Patients will feel pain when having the digital rectal examination. The examination of skin, mucosa, tongue, joints and eyes are extremely important.