Diagnosis-ulcerative colitis

• Colonoscopy: involves rectum (95%) & extends prox., circumfer., & contig. w/in colon

• Location: proctitis (30–60%), L-sided (15–45%) and extensive (pancolitis; 15–35%)

• Appearance: vascularity loss, friable mucosa, diffuse ulceration, pseudopolyps (chronicity)

• Histology: superficial chronic inflammation; crypt abscesses & architectural distortion

• Barium enema with featureless and tubular appearance of colon (leadpipe appearance)

• Flares: ↑ ESR & CRP (not Se or Sp); ⊕ fecal calprotectin helpful in distinguishing IBD vs. IBS and monitoring for IBD flare (Gastro Hep 2017;13:53); must rule out infection