What is involved in the inflammation of the colon in inflammatory bowel disease (IBD)?

Updated: Oct 17, 2017
  • Author: William A Rowe, MD; Chief Editor: BS Anand, MD  more...
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Answer

Inflammation in ulcerative colitis almost always involves the rectum and is contiguous, regardless of the extent of the colon involved. The exception to this rule is that the initial inflammation may appear patchy during colonoscopy that is performed very early in the ulcerative colitis process, although biopsy specimens of the intervening normal-appearing mucosa often do reveal inflammation. The intestinal inflammation of ulcerative colitis only involves the colon. Biopsy specimens demonstrate neutrophilic infiltrate along with crypt abscesses and crypt distortion. Granulomas do not occur in ulcerative colitis. (See the following images.)

Chronic architectural changes in ulcerative coliti Chronic architectural changes in ulcerative colitis. Note the crypt branching and irregularity of size and shape, with an increase in chronic inflammatory cells in the lamina propria.
Low-power image of a colon biopsy specimen in a pa Low-power image of a colon biopsy specimen in a patient with ulcerative colitis illustrates changes limited to the mucosa. These changes include chronic alterations of the crypt architecture and an increase in chronic inflammatory cells in the lamina propria.
Chronic architectural changes in ulcerative coliti Chronic architectural changes in ulcerative colitis. Note the trifid crypt.

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