diagnosis of ulcerative colitis

Last reviewed 01/2018

A gold standard method for diagnosis of Ulcerative colitis is not currently available (1).

Diagnosis of ulcerative colitis is achieved through a combination of medical history, clinical evaluation and supported by the typical endoscopic and histological findings (1):

  • proctosigmoidoscopy or colonoscopy with characteristic changes of ulcerative colitis (loss of the typical vascular pattern, granularity, friability, and ulceration)
  • biopsy - to distinguish UC from infectious colitis
  • negative stool examination - for infectious causes (2)

Initial laboratory investigation methods for patients with active disease at presentation include:

  • full blood count - may reveal thrombocytosis, anaemia, leucocytosis
  • inflammatory markers (CRP or ESR)
  • electrolytes
  • liver function tests
  • a stool sample for microbiological testing (1)

A number of autoantibodies especially perinuclear antineutrophil cytoplasmic antibodies (pANCA) have been identified in patients with UC. (approximately 50-60% of patients are found to be positive for pANCA). Due to the low sensitivity of pANCA for the diagnosis of UC it cannot be used as a diagnostic tool (1)