Carcinoma Ulcerative colitis

The risk of colonic carcinoma is much greater in patients with ulcerative colitis as compared with the general population. 

Speciai risk Use with caution in the following situations Nonspecific ulcerative colitis if there is a probability of impending perforation, abscess, or other pyogenic infection diverticulitis fresh intestinal anastomoses hypertension CHF thromboembolitic tendencies thrombophlebitis osteoporosis exanthema Cushing syndrome antibiotic-resistant infections convulsive disorders metastatic carcinoma myasthenia gravis vaccinia varicella diabetes mellitus hypothyroidism, cirrhosis (enhanced effect of corticosteroids). 

A major indication for colon-specific drug delivery is in the treatment of local disorders of the colon, such as inflammatory bowel disease (IBD which includes ulcerative colitis and Crohn s disease) and carcinoma of the colon. The colon can also be used as an absorption site for the delivery of drags to the systemic circulation. Although absorption from the colon is generally considerably lower than from the small intestine, systemic drag delivery via the colon is associated with a number of advantages, including ... 

Approximately 11% of patients with ulcerative colitis are reported to have hepatobiliary complications with frequencies ranging from 5% to 95% in IBD patients overall. Hepatic complications include fatty liver, pericholangitis, chronic active hepatitis, and cirrhosis. Biliary complications include sclerosing cholangitis, cholangio-carcinoma, and gallstones. 

Bleeding with Crohn s disease is usually not as severe as with ulcerative colitis, although patients with Crohn s disease may have hypochromic anemia. Also, as with ulcerative colitis, the risk of carcinoma is increased but not as greatly as with ulcerative colitis. 

Harpaz N, Peck AL, Yin J, et al. p53 protein expression in ulcerative colitis-associated colorectal dysplasia and carcinoma. Hum Pathol. 1994 25 1069-1074. 

Reznik Y, Dao T, Coutant R, et al (2004) Hepatocyte nuclear factor-1 alpha gene inactivation cosegregation between liver adenomatosis and diabetes phenotypes in two maturity-onset diabetes of the young (MODY)3 families. J Clin Endocrinol Metab 89 1476-1480 Russmann S, Zimmermann A, Krahenbuhl S, et al (2001) Veno-occlusive disease, nodular regenerative hyperplasia and hepatocellular carcinoma after azathioprine treatment in a patient with ulcerative colitis. Eur J Gastroenterol Hepatol 13 287-290... 

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