Ulcerative colitis in Kingdom of Saudi Arabia

Abstract

Ulcerative colitis (UC) is an inflammatory disease of the large intestine affecting mucosal lining of rectum (proctitis), rectum to splenic flexure (left-sided colitis), or entire colon (pancolitis). Common symptoms include diarrhea, blood in the stool, mucus in the stool, fecal urgency, tenesmus, abdominal pain, and constipation. Biochemical findings may include iron deficiency anemia, increased serum platelets, deficiency of serum albumin, presence of auto-immunoglobulins, and anti-neutrophil cytoplasmic antibodies. Currently, its complete pathophysiology is unclear, however, primary pathological features comprise disturbance in gastrointestinal mucosal barrier, abnormal gut immune responses, and imbalance in gut microbiota. In Saudi Arabia, a rise in incidence and prevalence of UC is observed, however, evidence is limited. Common risk factors include age, gender, race, ethnicity, family history, microbiome profile, medical history, and lifestyle elements. Antibiotics exposure at an early age, long-term use of non-steroidal anti-inflammatory drugs, and using oral contraceptives is associated with increased risk of UC. Management guidelines for the treatment of UC have been provided by the American Gastroenterological Association and the American College of Gastroenterology providing guidelines for therapeutic options and surgery. Development of personalized therapeutics and targeted treatment strategies based on genetic as well as cellular data are recommended as future potentials in the management of UC patients.