ulcerative colitis
DiseaseWikipedia
51
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15
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Search complete. 51 mentions across 15 episodes found for "ulcerative colitis".
Sep 10, 2026
Muyiwa AwoniyiGUEST
The background of this paper is a clinical paradox that I think most people who look after these patients have felt, but that we haven't been able to explain.
Muyiwa AwoniyiGUEST
Up to 80% of patients with primary sclerosing cholangitis, or PSC, also have inflammatory bowel disease, or IBD, and a great majority of that is ulcerative colitis-like phenotype.
Muyiwa AwoniyiGUEST
So the textbook description of primary sclerosing, cholangitis, or PSC-associated ulcerative colitis, as I will refer to it as PSC-UC, is a mild-looking pancolitis often with right-sided predominance, relative rectal sparing, and backwash ileitis.
Muyiwa AwoniyiGUEST
Many of these patients have very few bowel symptoms, and yet this is one of the highest risk groups for colorectal neoplasia in the whole of gastroenterology, and the cancers arrive earlier and disproportionately in the proximal colon.
Muyiwa AwoniyiGUEST
That is uncomfortable because almost everything we do in ulcerative colitis surveillance is built on inflammatory burden, which is the extent, the duration, and the severity of inflammation as the key driver of cancer risk.
Muyiwa AwoniyiGUEST
In PSC-UC, that logic appears to break down.
Muyiwa AwoniyiGUEST
The endoscopic appearance alone simply does not track with cancer risk.
Muyiwa AwoniyiGUEST
the microbiome is much more attractive candidate.
JD DenhamHOST
I am on the carnivore diet.
JD DenhamHOST
I have ulcerative colitis and have gone into remission by diet and lifestyle changes." Good for you.
JD DenhamHOST
"I've noticed on R-"
William T. HaasHOST
For sure
William T. HaasHOST
Um, and KPV for your, for your UC, heck yeah, do it.
William T. HaasHOST
I wouldn't...
William T. HaasHOST
And, you know, with that U- with the ulcerative colitis, just be careful about changing a whole bunch of things at once, right? Like, that's something you do not want to persist.
William T. HaasHOST
And so if something throws off and takes you out of remission, it'd be nice to know what it is instead of changing a bunch of things all at once.
Amit AssaGUEST
So this is a real bridge in resultive colitis for a drug that in moderate to severe cannot induce remission such as 5-ASA.
Amit AssaGUEST
So in UC, a bridge for 5-ASN, even for azathioprine, which can be a good drug in ulcerative colitis.
Amit AssaGUEST
For Crohn's disease, it's not the same.
Amit AssaGUEST
We know from the SONIC trial that only 16% of Crohn's disease patients will achieve endoscopic remission with thiopurines.
5 MINS LATER
Amit AssaGUEST
It's not top-down from biologics to non-advanced therapy.
Amit AssaGUEST
It's top-down for high-dose biologics to a lower-dose maintenance biologics.
Chris BakewellHOST
Yeah, they seem to be uncoupling UC and Crohn's.
Chris BakewellHOST
They're getting more and more separate, but interesting.
Joe HadenHOST
If not, go get...
Joe HadenHOST
You got to...
Joe HadenHOST
Josh Allen was in the same draft as Baker Mayfield, as the same draft as, what's my boy's name? I will never forget from UCLA that went seventh pick overall.
Joe HadenHOST
You said you'll never forget, but you can't remember his name.
Joe HadenHOST
Rosen, Josh Rosen.
Jessica AllegrettiGUEST
So that's often the term we use to describe that.
Jessica AllegrettiGUEST
With regards to sort of remission and remission assessments as well, I mentioned earlier, right, there is often... poor correlation between, especially in Crohn's, but it does exist in UC as well, between again, achieving clinical remission and endoscopic remission.
Jessica AllegrettiGUEST
And so even if you feel better, you know, you, the patient, you feel better and you're wondering like, why do I need to keep doing another stool test or another endoscopic assessment? It's because we know you may not have achieved both goals.
Jessica AllegrettiGUEST
And it's really paramount that we get you not only to clinical remission, but also endoscopic remission or at least endoscopic response as well.
Jared HendrenHOST
Let's talk through another case.
Jared HendrenHOST
Let's say you have a 34-year-old woman with refractory UC who's failed medical management and is undergoing a total abdominal colectomy with an endoleostomy.
Jared HendrenHOST
Intraoperatively, her small bowel mesentery is thick and foreshortened, and the TI just won't reach the fascia without tension.
Jared HendrenHOST
What's your approach here?
Roni ValmeGUEST
So if I think about my own journey...
Roni ValmeGUEST
The first time I was diagnosed with, I have to call it at the time, it was UC, colitis, pancolitis, whatever you want to call it.
Roni ValmeGUEST
No one ever said IBD, right? It was just they did a colonoscopy on me.
Roni ValmeGUEST
I was having some issues and we might even get into that.
6 MINS LATER
Roni ValmeGUEST
I said, hey, Dr. Lewis, I think I've got a problem.
Roni ValmeGUEST
Can you scope me or do something? And so sure enough, he scoped me and said, oh, yeah, this is back in 2006.
Roni ValmeGUEST
You know, hey, you have what we call pan UC.
Roni ValmeGUEST
You're just bleeding everywhere.
Dane JohnsonGUEST
I got this opportunity, this, that, and the other.
Dane JohnsonGUEST
And ulcerative colitis was like God trying to hold on to me.
Andy LambHOST
The thing that was killing you saved your life.
Dane JohnsonGUEST
and it can lead to every single disease that could kill any person.
Johnny HansenHOST
And we know many people deal with debilitating diseases and that those diseases don't just affect the body.
Johnny HansenHOST
They affect the mind and the spirit.
Johnny HansenHOST
Andy has a personal experience with this with ulcerative colitis.
Johnny HansenHOST
And it's the way that it's affected his, the way that he is, the guy that he usually is.
speaker_4HOST
It really is.
speaker_4HOST
The text contrasts two absolute heavyweights here, ulcerative colitis and Crohn colitis.
speaker_4HOST
Let's start with the radiographic hallmarks of ulcerative colitis, or UCI.
speaker_5HOST
Well, with UC, the colon loses its normal, you know, those normal segmented pouches.
speaker_4HOST
Right.
Dane JohnsonGUEST
And how do we know? Because IBD didn't even exist before the 1950s.
Dane JohnsonGUEST
There was a few random cases of some of the bleeding and Yoni's disease, which was basically ulcerative colitis of the cow.
Dane JohnsonGUEST
And there was a few random things.
Dane JohnsonGUEST
But if you look at the epidemic, again, it's parallel with that westernization.
Dane JohnsonGUEST
So symptom profile, Crohn's disease, the two most common mentioned symptoms actually of Crohn's disease in a clinical research article I was looking at was fatigue and pain.
Dane JohnsonGUEST
And that was like 80 to 85% of a sample size of 250 people had mentioned those.
Dane JohnsonGUEST
And then of the sample of ulcerative colitis, I think it was 150, the two most common symptoms were blood in the stool and diarrhea slash urgency.
Dane JohnsonGUEST
And so ulcerative colitis is more of a problem of the colon.
5 more episodes mention ulcerative colitis.
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