Name of the Condition

• Ulcerative colitis, unspecified with unspecified complications

Summary

• Ulcerative colitis is a chronic inflammatory condition affecting the colon and rectum. It causes ulcers and inflammation in the lining of the large intestine, leading to discomfort and digestive issues.

Causes

• The exact cause of ulcerative colitis is unknown, but it is thought to result from an abnormal immune response. Genetics, environmental factors, and imbalances in gut bacteria may also contribute.

Risk Factors

• Risk factors include a family history of ulcerative colitis, being of Caucasian or Ashkenazi Jewish descent, and being in early adulthood to middle age, typically between 15 and 30 years old.

Symptoms

• Common symptoms include abdominal pain, persistent diarrhea, rectal bleeding, an urgent need to defecate, and weight loss. Symptoms can vary in severity and may have periods of remission.

Diagnosis

• Diagnosis often involves a combination of blood tests, stool samples, colonoscopy, and imaging studies like CT scans to assess inflammation and exclude other conditions.

Treatment Options

• Treatments include anti-inflammatory drugs, immune system suppressors, and biologics to reduce inflammation and manage symptoms. In severe cases, surgery to remove the colon may be necessary.

Prognosis and Follow-Up

• With proper management, many individuals with ulcerative colitis can lead normal lives. Regular follow-ups help monitor disease activity and prevent complications.

Complications

• Complications can include increased risk of colon cancer, severe bleeding, perforated colon, and dehydration. Poorly managed ulcerative colitis can also lead to extra-intestinal issues like arthritis and liver disease.

Lifestyle & Prevention

• Management includes adhering to medication regimens, eating anti-inflammatory diets, managing stress, and regular medical checkups. There is no known prevention, but these measures can minimize flare-ups and complications.

When to Seek Professional Help

• Immediate medical attention is required for symptoms like severe abdominal pain, rapid weight loss, high fever, persistent diarrhea containing blood, or signs of dehydration.

Additional Resources

• Resources such as the Crohn’s & Colitis Foundation provide support and information. Other valuable resources are the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and Mayo Clinic.

Tips for Medical Coders

• Ensure to distinguish between ulcerative colitis with specific complications versus unspecified complications for accurate coding. Avoid using unspecified codes when details are available in the patient's medical records.