Ulcerative Colitis

Silvio Danese, M.D., and Claudio Fiocchi, M.D.

N Engl J Med 2011; 365:1713-1725November 3, 2011

Article
References: Ulcerative colitis was first described in the mid-1800s,1 whereas Crohn's disease was first reported later, in 1932, as “regional ileitis.”2 Because Crohn's disease can involve the colon and shares clinical manifestations with ulcerative colitis, these entities have often been conflated and diagnosed as inflammatory bowel disease, although they are clearly distinct pathophysiological entities. Ulcerative colitis is the most common form of inflammatory bowel disease worldwide. In contrast to Crohn's disease, ulcerative colitis is a disease of the mucosa that is less prone to complications and can be cured by means of colectomy, and in many patients, its course is mild.3 The literature on the pathogenesis and treatment of so-called inflammatory bowel disease has tended to focus on Crohn's disease,4-7 and few articles expressly discuss ulcerative colitis.8,9 Here we review our current understanding of the pathophysiology, diagnosis, and treatment of ulcerative colitis to date; we also compare ulcerative colitis with Crohn's disease and refer to both as inflammatory bowel disease according to the context.