LYCOS RETRIEVER 
Colitis: Patients
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Patients with ulcerative colitis usually have an intermittent course, with periods of disease inactivity alternating with "flares" of disease. Patients with proctitis or left-sided colitis usually have a more benign course: only 15% progress proximally with their disease, and up to 20% can have sustained remission in the absence of any therapy. Patients with more extensive disease are less likely to sustain remission, but the rate of remission is independent of the severity of disease.
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This is an extremely complex surgery that should be performed only by a skilled colorectal surgeon with extensive experience in treating ulcerative colitis. Following this surgery at The Cleveland Clinic, the average patient has between six and eight bowel movements per day. More than 97 percent of patients are satisfied with the outcome of their operation, and the majority do not require further medical care related to the surgery, outside of routine post-operative follow-up.
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C[L]ostridium difficile colitis occurs in about 20% of hospitalized patients taking antibiotics (1). Most patients treated for this infection improve, but about 20% relapse (2). Relapse is defined as recurrence of symptoms and documentation of infection within 2 months of successful standard therapy. Patients with relapsing C difficile colitis are prone to further relapses, each one making eradication more difficult.
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Patients with more severe diarrhea or colitis should receive antibiotic therapy directed at C difficile. More than 95% of patients respond to 10 days of treatment with vancomycin (oral) or metronidazole (oral or intravenous). Symptomatic improvement can be expected within 2-3 days. Prompt therapy with vancomycin (oral) or metronidazole may control the colitis and prevent perforation in severe cases.
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The clinical presentation[10] of ulcerative colitis depends on the extent of the disease process. Patients usually present with diarrhea mixed with blood and mucus, of gradual onset. They ... may have signs of weight loss, and blood on rectal examination. The disease is usually accompanied with different degrees of abdominal pain, from mild discomfort to severely painful cramps.
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Intermittent rectal bleeding, crampy abdominal pain and diarrhea can be symptoms of ulcerative colitis. Ulcerative colitis characteristically waxes and wanes. Many patients experience long remissions, even without medication. Ulcerative colitis may mysteriously resolve ("burn out") after a long history of symptoms.
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