Ulcerative Colitis

Instructions: Read the case study and answer the questions. Make sure you include the pathological rationale
for each answer;
Bruce Sawyer is a 25-year-old male in a stressful, professional position. He was recently diagnosed with
ulcerative colitis (UC) after developing abdominal pain and cramping and bloody diarrhea intermittently
(though more frequently recently) over the last several weeks. He has lost 10 pounds in the last 4 weeks and
has complained of nausea and fatigue. A colonoscopy demonstrated the presence of significant inflammation
and ulcers in the colon and rectum. No strictures, perforations, or areas of paralysis of the colon were noted.
Biopsy and further evaluation of the colonoscopy confirmed the presence of UC and ruled out Crohn’s
disease. He has no family history of inflammatory bowel disease. Assessment of the skin revealed the
presence of erythema nodosum lesions, which are characteristic of UC. Laboratory testing further identified
the presence of lowered red blood cell (RBC) and hemoglobin levels, elevated platelet count, and normal
white blood cell (WBC) count. Serum total protein and albumin levels were low.
This case study notes that a colonoscopy demonstrated the presence of significant inflammation. What would
the examiner actually have seen that supports this conclusion?
This case study also notes Mr. Sawyer may need to have surgery for a colostomy or ileostomy at some point
in his life because tissue damage to the intestinal tract may be so severe that it no longer functions. How
would you explain the cause of this damage?