Ulcerative colitis (UC) is a chronic inflammatory bowel disease associated with considerable disease burden. We review some current misconceptions about UC in adults with the aim of optimizing care for patients. Although UC and Crohn's disease (CD) are considered discrete diseases, distinctions between them are not always clear-cut and phenotypes may change over time. Patient management should take into account disease manifestations, disease severity and extent, and response to prior treatments. Although disease extent often defines severity, distal UC is not always less disabling than extensive disease as patients can progress to more extensive disease. In addition, severe proctitis can give rise to severe and debilitating symptoms, with a substantial impact on health-related quality of life. UC carries an increased risk of colorectal cancer (CRC) compared with CD; however, more recent data indicate a similar risk of CRC in CD with colonic involvement as with UC. Corticosteroids are widely used to induce remission in UC, and prolonged use of steroids in patients with UC is common, but corticosteroid-free maintenance of remission is an important therapeutic goal. Although biologic therapies provide a valuable treatment option in UC, they are not clinically effective in all patients and are also associated with secondary loss of response.

中文翻译：

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溃疡性结肠炎：流沙。

溃疡性结肠炎（UC）是一种慢性炎症性肠病，伴有大量疾病负担。我们复习了一些有关成人UC的最新误解，目的是优化对患者的护理。尽管UC和克罗恩氏病（CD）被认为是离散性疾病，但它们之间的区别并不总是很明确，表型可能会随着时间而改变。患者管理应考虑疾病表现，疾病严重程度和程度以及对先前治疗的反应。尽管疾病程度通常定义了严重程度，但远端UC的残障并不总是比广泛疾病少，因为患者可以发展为更广泛的疾病。此外，严重的直肠炎会引起严重的使人虚弱的症状，对健康相关的生活质量产生重大影响。与CD相比，UC导致大肠癌（CRC）的风险增加；然而，最近的数据表明，结肠受累的CD患CRC的风险与UC相似。皮质类固醇被广泛用于诱导UC缓解，在UC患者中长期使用类固醇是很常见的，但是无皮质类固醇维持缓解是重要的治疗目标。尽管生物疗法在UC中提供了有价值的治疗选择，但它们并非在所有患者中都具有临床疗效，而且还与继发性反应丧失有关。但是无皮质类固醇维持缓解是重要的治疗目标。尽管生物疗法在UC中提供了有价值的治疗选择，但它们并非在所有患者中都具有临床疗效，并且还与继发性反应丧失有关。但是无皮质类固醇维持缓解是重要的治疗目标。尽管生物疗法在UC中提供了有价值的治疗选择，但它们并非在所有患者中都具有临床疗效，而且还与继发性反应丧失有关。