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Ulcerative Colitis — RACP Adult Medicine MCQ

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EasyGastroenterologyUlcerative ColitisRACP Adult Medicine

A 42-year-old woman presents with 6 weeks of bloody diarrhoea, urgency, and tenesmus. Colonoscopy shows continuous mucosal inflammation extending from the rectum to the splenic flexure with loss of vascular pattern and contact bleeding. Biopsies show crypt abscesses and goblet cell depletion. What is the most likely diagnosis?

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Correct answer: A — Ulcerative colitis

Continuous mucosal inflammation starting from the rectum with crypt abscesses and goblet cell depletion on biopsy is characteristic of ulcerative colitis. The left-sided distribution (to splenic flexure) represents E2 disease in the Montreal classification. Initial treatment is with mesalazine (topical and oral).

Reference: Gastroenterological Society of Australia – 2024 – IBD Guidelines