Ulcerative Colitis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further:
    • Inspection (viewing).
      • Skin and mucous membranes [erythema nodosum (nodular erythema), localization: Both extensor sides of the lower leg, on the knee and ankle joints; less commonly on the arms or buttocks; erythema (extensive redness of the skin)); pyoderma gangraenosum (painful disease of the skin in which ulceration or ulceration (ulceration or ulceration) occurs over a large area, usually in one place, and gangrene (tissue death due to reduced blood flow or other damage))]
      • Eyes [uveitis (inflammation of the uvea (middle skin of the eye); iridocyclitis (inflammation of the iris); episcleritis (inflammation of the connective tissue between the sclera and conjunctiva of the eye)]
      • Oral cavity [stomatitis aphtosa (mouth rot)]
      • Abdomen (abdomen)
        • Shape of the abdomen?
        • Skin color? Skin texture?
        • Efflorescences (skin changes)?
        • Pulsations? Bowel movements?
        • Visible vessels?
        • Scars? Hernias (fractures)?
    • Auscultation (listening) of the heart [palpitations].
    • Auscultation of the lungs
    • Examination of the abdomen (belly)
      • Percussion (tapping) of the abdomen
        • Meteorism (flatulence): hypersonoric tapping sound.
        • Attenuation of tapping sound due to enlarged liver or spleen, tumor, urinary retention?]
      • Palpation (palpation) of the abdomen (abdomen) (pressure pain?, knock pain?, cough pain?, defensive tension?, hernial orifices?, kidney bearing knock pain?) [due todifferential diagnosis: appendicitis (appendicitis)]
    • Digital rectal examination (DRU): examination of the rectum (rectum) [main leading symptom: mucopurulent, bloody diarrhea (diarrhea); painful bowel movements; increased stool frequency (up to 30 bowel movements per day); feeling of incomplete defecation; intestinal colic][due todifferential diagnoses:
      • Crohn’s disease (inflammatory bowel disease (IBD))
      • Rectal ulcer (rectal ulcer)]
  • Cancer screening [due todifferential diagnoses:
    • Familial adenomatous polyposis (FAP; synonym: polyposis coli) – autosomal-dominant inherited disease that causes polyps in the colon.
    • Colon carcinoma (colon cancer)
    • Lymphoma (malignant disease originating in the lymphatic system)]

    [due topossible secondary disease: colon carcinoma (colon or rectal cancer) – after more than ten years of disease progression, the risk of colon cancer is increased and in extensive ulcerative colitis even 15-fold increased].

  • If necessary, ophthalmological examination [due topossible extraintestinal manifestation/signs of disease outside the gastrointestinal tract: uveitis (inflammation of the uvea (middle eye skin); iridocyclitis (inflammation of the iris); episcleritis (inflammation of the connective tissue between the sclera and conjunctiva of the eye)]
  • If necessary, orthopedic examination [due topossible secondary disease: osteoporosis (bone loss)]
  • If necessary, psychiatric examination [due topossible causes: depression, anxiety].
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.