ULCER
ULCERATIVE COLITIS
U
ulcer An open sore appearing on the
skin or on a
mucous membrane
that
results from the destruction of surface
tissue. Ulcers may be shallow, or deep
and crater-shaped, and they are usually
inflamed and painful.
Skin ulcers most commonly occur on
the leg (see
leg ulcer),
usually as the
result of inadequate blood supply to, or
drainage from, the limb. In some cases
skin cancers, particularly
basal cell car-
cinomas
or
squamous cell carcinomas,
may be ulcerated. Rarely, a cancer may
develop in the skin at the edge of a
longstanding ulcer.
The most common types of ulcers of
the mucous membranes are
mouth ul-
cers, peptic ulcers,
and those that occur
in
ulcerative colitis.
Ulcers may also affect the skin or
mucous membranes of the genitalia
(see
genital ulcer).
Most genital ulcers are
caused by sexually transmitted infec-
tions. Examples of this type of ulcer are
hard chancres (see
chancre, hard),
which
develop during the first stage of
syph-
ilis
, and soft chancres (see
chancroid
).
In addition, ulcers may develop on the
cornea (see
corneal ulcers
).
ulcer, aphthous A small, painful
ulcer
that occurs, alone or in a group, on the
inside of the cheek or lip or underneath
the tongue. Aphthous ulcers are most
common between the ages of 10 and 40
and affect more women than men. The
most severely affected people have con-
tinuously recurring ulcers; others have
just
1
or
2
ulcers each year.
Each ulcer is usually small and oval,
with a grey centre and a surrounding
red, inflamed halo. The ulcer, which
usually lasts for
1 - 2
weeks, may be a
hypersensitive reaction to haemolytic
streptococcus
bacteria.
Other factors
commonly associated with the occur-
rence of these ulcers are minor injuries
(such as at an injection site or from a
toothbrush), acute stress, or allergies
(such as allergic
rhinitis
). In women,
aphthous ulcers are most common dur-
ing the premenstrual period. They may
also be more likely if other family mem-
bers suffer from recurrent ulceration.
Analgesic mouth gels or mouthwashes
may ease the pain of an aphthous ulcer.
Some ointments form a waterproof cov-
ering that protects the ulcer while it is
healing. Ulcers heal by themselves, but
a doctor may prescribe a paste contain-
ing a
corticosteroid drug
or a mouthwash
containing an
antibiotic drug
to speed
up the healing process.
ulceration The formation or presence
of
1
or more
ulcers.
ulcerative colitis Chronic inflammation
and ulceration of the lining of the
colon
and
rectum
, or, especially at the start of
the condition, of the rectum alone. The
cause of ulcerative colitis is unknown,
but the condition is most common in
young and middle-aged adults.
The main symptom of ulcerative coli-
tis is bloody diarrhoea; and the faeces
may also contain mucus. In severe
cases, the diarrhoea and bleeding are
extensive, and there may be abdominal
pain and tenderness, fever, and general
malaise. The incidence of attacks varies
considerably. Most commonly, the at-
tacks occur at intervals of a few months.
However, in some cases, there may be
only a single episode.
Ulcerative colitis may lead to
anaemia
,
caused by blood loss. Other complica-
tions include a toxic form of
megacolon
,
which
may become
life-threatening;
rashes; aphthous
ulcers
;
arthritis
;
con-
junctivitis;
or
uveitis.
There is also an
increased risk of cancer of the colon
developing (see
colon, cancer
of).
A diagnosis is based on examination
of the rectum and lower colon (see
sigmoidoscopy
) or the entire colon (see
colonoscopy
), or is made by a barium
enema (see
barium X-ray examination).
During sigmoidoscopy or colonoscopy,
a
biopsy
may be performed. Samples of
faeces may be taken for laboratory anal-
ysis in order to exclude the possibility
of infection by bacteria or parasites.
Blood tests
may also be needed.
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