Second, A short course of antibiotic therapy proved effective in patients with any stage of UC. We cannot exclude the possibility that other agents are responsible for UC owing to the complexity of the colonic ecosystem. Most bacteria live within the lumen and do not enter the mucosa, so microbiological investigations of rectal biopsy samples may provide more solid evidence. Making the initial diagnosis of UC in patients with concomitant bacterial infections and diffuse continued mucosal inflammation in the colonoscopy is challenging.
The combination of bloody diarrhea in a young adult and poor response to antibiotic treatment is an important clue to the possibility of undiagnosed UC.
Follow-up colonoscopy with a biopsy wound help provide solid evidence for UC diagnosis. The authors would like to thank all gastroenterology faculty of MacKay Memorial Hospital for excellent clinical assistance and care. National Center for Biotechnology Information , U. PLoS One. Published online Dec 6. John Green, Editor. Author information Article notes Copyright and License information Disclaimer. Competing Interests: The authors have declared that no competing interests exist.
Received Sep 10; Accepted Nov This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This article has been cited by other articles in PMC. Abstract Ulcerative colitis UC is a chronic inflammation of the large bowel characterized by diarrhea and a negative stool culture. Introduction Ulcerative colitis UC , an inflammatory bowel disease IBD involving the large bowel, is characterized by the presence of diarrhea and bloody mucoid stool.
Data collection The database included computerized medical records of demographic data including age, sex, and underlying comorbidities. Open in a separate window.
Infection in UC Seventeen UC patients with a concomitant bacterial infection were enrolled; of them, eight were initially diagnosed Table 2. Table 2 Clinical characteristics of UC patients with a concomitant infection. Histological features Biopsies were performed at the time of infection in 15 of 17 patients with UC and 27 of 46 patients with chronic IC Table 3. Pathogenicity of different species Aeromonas species was the most common pathogen in Discussion Diarrhea was long thought to be caused by infectious agents such as bacteria.
Limitations First, because bacterial infection is rarely a cause of chronic diarrhea and UC, the small sample size and retrospective design of this study might have led to patient selection bias. Conclusions Making the initial diagnosis of UC in patients with concomitant bacterial infections and diffuse continued mucosal inflammation in the colonoscopy is challenging.
DOCX Click here for additional data file. Acknowledgments The authors would like to thank all gastroenterology faculty of MacKay Memorial Hospital for excellent clinical assistance and care.
Funding Statement The authors received no specific funding for this work. Data Availability All relevant data are within the paper and its Supporting Information file. References 1. Intestinal Research ; 15 3 : — Campieri M, Gionchetti P. Bacteria as the cause of ulcerative colitis.
Gut ; 48 : —5. Sasaki M, Klapproth JM. The role of bacteria in the pathogenesis of ulcerative colitis. Journal of Signal Transduction ; : doi: Acute gastroenteritis is followed by an increased risk of inflammatory bowel disease. Gastroenterology ; 6 : — A prospective study of first attacks of inflammatory bowel disease and non-relapsing colitis. Microbiologic findings. Scand J Gastroenterol ; 28 12 : — Microbial factors in chronic intestinal inflammation. Curr Opp Gastroenterol ; 12 4 : — Inflammatory bowel disease and Aeromonas infection: a commensal or an initiating agent or a causative agent?
The American Journal of Gastroenterology ; 98 9 : S Aeromonas species: an opportunistic enteropathogen in patients with inflammatory bowel diseases? A single center cohort study. Inflamm Bowel Dis ; 21 1 : 71—8. AGA technical review on the evaluation and management of chronic diarrhea. In some areas, you may be able to have some choice over which hospital you go to if you have been referred through the NHS e-Referral Service.
It may take some time to get an appointment with your gastroenterology team. The IBD Standards state that you should have a specialist assessment within four weeks of being referred, but it may sometimes take longer. You can also talk to your GP about how best to manage your symptoms while you wait for an appointment, and what to do if you start to feel worse. Your doctor will need to take a look directly at your gut to check if you have these ulcers.
This is done by an endoscopy. In an endoscopy, a doctor or specialist endoscopist uses an endoscope — a long, thin tube with a camera in its tip — to examine your digestive system. There are several types of endoscopy which can have different names according to the part of the gut being examined.
The main types are:. Upper Gastrointestinal GI Endoscopy or Gastroscopy This type of endoscopy goes through your mouth, and is used to examine the upper part of the digestive system — the oesophagus, stomach, and duodenum first part of the small intestine.
Colonoscopy A colonoscopy goes through your bum back passage to look at the whole of the large intestine, including rectum and colon. Sigmoidoscopy or Proctosigmoidoscopy This is similar to colonoscopy but only examines the rectum and lower part of the colon.
If you have any worries about your endoscopy, discuss them in advance a with your healthcare professional. Endoscopies may be uncomfortable, so you may be offered a sedative to help you relax, but they are normally not painful.
Biopsies small samples of tissue from the gut are often taken during an endoscopy. These can then be examined under a microscope to confirm the diagnosis. Some hospitals may offer a capsule endoscopy , which is a special sort of endoscopy where you swallow a tiny camera which passes through the digestive system, taking photos of the inside of the gut.
Back to Ulcerative colitis. To diagnose ulcerative colitis, your GP will first ask about your symptoms, general health and medical history. They'll also physically examine you, checking for signs such as paleness caused by anaemia and tenderness in your tummy caused by inflammation.
A stool sample can be checked for signs of infection, as gastroenteritis infection of the stomach and bowel can sometimes have similar symptoms to ulcerative colitis.
Blood tests may also be carried out to check for anaemia and to see if there's inflammation on any part of your body. If your GP suspects you may have inflammatory bowel disease IBD a term mainly used to describe 2 diseases: ulcerative colitis or Crohn's disease , you may be referred to hospital for further tests. These could include an X-ray or CT scan to rule out serious complications and a detailed examination of your rectum and colon.
A diagnosis of ulcerative colitis can be confirmed by examining the level and extent of bowel inflammation. This is initially done by using a sigmoidoscope, a thin, flexible tube containing a camera that's inserted into your rectum bottom.
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