Medical expert of the article
New publications
Ulcerative colitis: pathogenesis
Last reviewed: 23.04.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
The main pathogenetic factors of nonspecific ulcerative colitis are:
- dysbacteriosis of the intestine - a violation of the normal composition of microflora in the large intestine, which has a local toxic and allergic effect, and also promotes the development of non-immune inflammation of the colon;
- violation of neyrohumoralnoy regulation of bowel function, due to dysfunction of the vegetative and gastrointestinal endocrine system;
- a significant increase in the permeability of the colon mucosa for protein molecules and bacterial antigens;
- damage to the intestinal wall and the formation of autoantigens followed by the formation of autoantibodies to the intestinal wall. The antigens of some strains of E. Coli induce the synthesis of antibodies to colon tissue;
- the formation of immune complexes localized in the wall of the colon, with the development of immune inflammation in it;
- development of extraintestinal manifestations of the disease due to multifaceted autoimmune pathology.
Pathomorphology
With nonspecific ulcerative colitis develops a pronounced inflammatory process in the mucosa of the colon. Progressive destruction of the epithelium and the fusion of inflammatory infiltrates cause the development of mucosal ulcers.
In 70-80% of patients develops a characteristic sign of ulcerative colitis - microabscesses of the crypt of the large intestine. In chronic course, intestinal epithelial dysplasia and intestinal wall fibrosis are noted.
Most often with ulcerative colitis, distal parts of the colon and rectum are affected, the latter being involved in the pathological process in almost 100% of cases. 25% of patients develop pancolitis.
[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18]