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KOLITIS ULSERATIF
- BOOK READING-
dr. Ra Aditya Adhi PuruhitaPPDS Ilmu Penyakit Dalam
RSUP Prof.Dr.Sardjito
Pembimbing : dr. Eko Ariwibowo, Sp.PD - KGer
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KOLITIS ULSERATIF -DEFINISI-
Chronic
Inflammatory
Bowel Disease
Etiologi belumdiketahui
Hanya pada Colon
Klasifikasi :Distal Disease
More extensive
disease
Pancolitis
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KOLITIS ULSERATIF –
EPIDEMIOLOGI-
Lebih sering terjadi dibandingkan Crohn Disease
Insidensi:10 per 100,000
Usia: 1) 15-25 th (paling sering)
2) 55-65 thMale:Female= 1:1
Idiopathic: autoimun yang tercetus karena
infeksi bakteri inflamasi
Genetik: 17 – 35 x resiko lebih tinggi padasaudara kandung yang menderita IBD
1) Ulcerative Colitis; NICE Clinical Guideline (Jun 2013)
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KOLITIS ULSERATIF- GEJALA
Diare berdarah
Nyeri perut
Tenesmus
Gejala sistemik : malaise, demam, penurunanberat badan
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KOLITIS ULSERATIF -PEMERIKSAAN
FISIK-
Pucat, demam, dehidrasi
Nyeri perut dan tendernes
Distensi Toxic Megacolon
Tanda lain: Takikardia, anaemia dan demamManifestasi ekstraintestinal (1/3 patients)
Proctitis and Proctosigmoiditis
– 50% pasien
– konstipasi 25% pasien
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KOLITIS ULSERATIF – CLINICAL
PRESENTATION
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KOLITIS ULSERATIF - KLASIFIKASI
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KOLITIS ULSERATIF -KLASIFIKASI
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KOLITIS ULSERATIF- EXTRA-
INTESTINAL
Aphthous ulcers
Manifestasi pada mata5%Episcleritis
Anterior uveitis
Acute arthropathy pada sendi-sendi besar26%Sacroiliitis
Ankylosing Spondylitis3%
Dermatologi19%Pyoderma gangrenosum
Erythema nodosum
Primary Sclerosing Cholangitis
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ULCERATIVE COLITIS-
INVESTIGATIONS
Bloods: FBC, CRP
Stool cultures
Imaging Abdo x-ray-
Barium enema- menggambarkan struktur mukosa
Flexible Sigmoidoscopy and Biopsy- untuk diagnosis
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KOLITIS ULSERATIF -
TATALAKSANA
a) Topical aminosalicylatealone (suppository or
enema
) !"## PO
aminosalicylate to a topical
aminosalicylate $%
c) consider an PO
aminosalicylate alone
a) PO "minosalicylate& 'i induction
dose o* an
) !"## topical
"minosalicylate $%
PO eclometasone
dipropionate
- I* no improvement +2rs despite IV
'ydrocortisone $%- ,ymptoms -orsen to
pancolitis.
a) "## IV Ciclosporin to IV
steroids
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Indikasi Pembedahan:Tidak berespon terhadap obat-obatan
Mengurangi kualitas hidup secara signifikan
Komplikasi yang mengancam jiwa :
Bleeding
Toxic Megacolon
Impending perforation
Carcinoma
KOLITIS ULSERATIF -
TATALAKSANA
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KOLITIS ULSERATIF VS CROHN
DISEASE
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Symptoms of Crohn's
Disease
/ Abdominal pain, cramping or
swelling
/ Anaemia
/Fever
/Gastrointestinal bleeding
/Joint pain
/Malabsorption
/Persistent or recurrent
diarrhoea
/Stomach ulcers
/ Vomiting
/Weight loss
Symptoms of Ulcerative
Colitis
/Bloody diarrhoea
/ Abdominal pain or discomfort/ Anaemia caused by severe
bleeding
/Dehydration
/Fatigue
/Fever
/Joint pain
/Loss of appetite
/Malabsorption
/Rectal bleeding
/Urgent bowel movements
/Weight loss
KOLITIS ULSERATIF VS CROHN
DISEASE
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