How are peptic ulcers diagnosed. What are the main symptoms of peptic ulcer disease. Which tests do doctors use to confirm peptic ulcers. What are the differences between gastric and duodenal ulcers. How can peptic ulcers be effectively treated.

Understanding Peptic Ulcer Disease: Types and Locations

Peptic ulcer disease is a condition characterized by open sores in the lining of the stomach or duodenum. These ulcers can be classified into two main types based on their location:

• Gastric ulcers: Located in the lining of the stomach
• Duodenal ulcers: Found in the lining of the duodenum (first part of the small intestine)

The distinction between these two types is crucial as it can influence both symptoms and treatment approaches. Gastric ulcers tend to cause pain that worsens with meals, while duodenal ulcers often lead to pain that improves after eating.

Recognizing the Symptoms of Peptic Ulcer Disease

Identifying peptic ulcer disease can be challenging due to its often nonspecific symptoms. However, some common signs include:

• Abdominal discomfort or pain
• Nausea
• Pain radiating to the back (potentially indicating ulcer penetration)
• Burning or gnawing sensation similar to hunger pains
• Pain aggravated by meals (possibly suggesting gastric ulcers)
• Pain relieved by meals (possibly indicating duodenal ulcers)

Are these symptoms always indicative of peptic ulcers? Not necessarily. Many of these symptoms can be associated with other gastrointestinal conditions, which is why proper diagnosis by a gastroenterologist is essential.

Diagnostic Approaches for Peptic Ulcer Disease

Diagnosing peptic ulcer disease involves a multi-step process that typically includes:

1. Comprehensive physical examination
2. Detailed medical history assessment
3. Specific diagnostic tests

What are the key diagnostic tests used to confirm peptic ulcers? Doctors may employ several methods:

Blood Tests

Blood tests can help detect signs of Helicobacter pylori (H. pylori) infection, a common cause of peptic ulcers. They can also identify potential complications associated with ulcers.

Urea Breath Test

This non-invasive test involves swallowing a capsule, liquid, or pudding containing labeled urea. If H. pylori is present, it will convert the urea into carbon dioxide, which can be detected in the patient’s breath.

Stool Tests

Stool samples can be analyzed to check for H. pylori infection. Patients are typically provided with a container and instructions for collection and submission of the sample.

Upper Gastrointestinal (GI) Endoscopy and Biopsy

This procedure allows doctors to directly visualize the upper GI tract using an endoscope. During the endoscopy, small tissue samples (biopsies) can be taken for further examination under a microscope.

Upper GI Series

Also known as barium contrast radiography, this test involves swallowing a chalky liquid (barium) and then taking X-rays of the upper GI tract. The barium coats the digestive tract, making it easier to detect abnormalities like ulcers.

The Role of H. pylori in Peptic Ulcer Disease

Helicobacter pylori is a bacterium that plays a significant role in the development of peptic ulcers. How does H. pylori contribute to ulcer formation? This spiral-shaped bacterium can survive in the harsh, acidic environment of the stomach and duodenum. It attaches to and damages the protective mucous coating of the stomach and small intestine, making the area more vulnerable to damage from stomach acid and pepsin.

Detecting H. pylori is crucial in the diagnosis and treatment of peptic ulcers. Several tests can identify the presence of this bacterium:

• Blood tests to check for antibodies against H. pylori
• Urea breath tests to detect the bacteria’s activity in the stomach
• Stool antigen tests to identify H. pylori proteins in fecal matter
• Tissue biopsies taken during endoscopy for direct examination of the bacteria

Treatment Strategies for Peptic Ulcer Disease

The treatment of peptic ulcers aims to relieve symptoms, heal the ulcer, and prevent recurrence. The specific approach depends on the underlying cause of the ulcer. What are the main treatment options available?

Antibiotics

If H. pylori infection is detected, a combination of antibiotics is typically prescribed to eradicate the bacteria. This may include clarithromycin, amoxicillin, or metronidazole, often given in conjunction with a proton pump inhibitor.

Proton Pump Inhibitors (PPIs)

These medications reduce stomach acid production, allowing the ulcer to heal. Common PPIs include omeprazole, lansoprazole, and pantoprazole.

Histamine Blockers (H2 Blockers)

H2 blockers also decrease stomach acid production, though they are generally less potent than PPIs. Examples include ranitidine and famotidine.

Antacids

Over-the-counter antacids can provide quick relief from ulcer pain by neutralizing stomach acid. However, they are not typically used as the primary treatment for peptic ulcers.

Cytoprotective Agents

Medications like sucralfate and misoprostol can help protect the lining of the stomach and small intestine from acid damage.

Lifestyle Modifications to Support Ulcer Healing

In addition to medical treatments, certain lifestyle changes can promote ulcer healing and prevent recurrence. What lifestyle modifications are recommended for patients with peptic ulcers?

• Avoiding or limiting alcohol consumption
• Quitting smoking
• Reducing stress through relaxation techniques or stress management programs
• Avoiding foods that trigger discomfort
• Eating smaller, more frequent meals instead of large meals
• Limiting or avoiding NSAIDs (nonsteroidal anti-inflammatory drugs) if they contributed to ulcer formation

These lifestyle changes, when combined with appropriate medical treatment, can significantly improve outcomes for patients with peptic ulcer disease.

Complications of Untreated Peptic Ulcers

While many peptic ulcers heal with proper treatment, untreated ulcers can lead to serious complications. What are the potential risks of leaving peptic ulcers untreated?

• Internal bleeding: Ulcers can erode blood vessels, causing potentially life-threatening blood loss.
• Perforation: Ulcers may create a hole through the stomach or small intestine wall, leading to peritonitis.
• Obstruction: Ulcers can cause swelling and scarring, potentially blocking the digestive tract.
• Gastric cancer: Long-standing ulcers, particularly those associated with H. pylori infection, may increase the risk of stomach cancer.

These complications underscore the importance of prompt diagnosis and treatment of peptic ulcer disease. Any persistent symptoms or signs of these complications should be immediately reported to a healthcare provider.

Preventive Measures for Peptic Ulcer Disease

While not all peptic ulcers can be prevented, certain strategies can reduce the risk of developing this condition. How can one lower their chances of getting peptic ulcers?

1. Practice good hygiene: Washing hands thoroughly and frequently can help prevent H. pylori infection.
2. Use NSAIDs cautiously: If you need to take NSAIDs regularly, consult with your doctor about protective measures or alternative pain management strategies.
3. Manage stress: Chronic stress may increase stomach acid production. Adopting stress-reduction techniques can be beneficial.
4. Maintain a healthy diet: Eating a balanced diet rich in fruits, vegetables, and whole grains may help protect the digestive system.
5. Limit alcohol consumption: Excessive alcohol can irritate and erode the mucous lining of the stomach and intestines.
6. Quit smoking: Smoking can interfere with the protective lining of the stomach, making it more susceptible to ulcers.

By adopting these preventive measures, individuals can significantly reduce their risk of developing peptic ulcers and promote overall digestive health.

The Future of Peptic Ulcer Treatment

As medical research advances, new approaches to treating and preventing peptic ulcers are emerging. What are some promising developments in the field of peptic ulcer disease management?

Novel H. pylori Eradication Strategies

Researchers are exploring new antibiotic combinations and delivery methods to improve H. pylori eradication rates and combat antibiotic resistance.

Probiotic Therapies

Studies are investigating the potential of probiotic supplements to support the gastric microbiome and enhance ulcer healing.

Targeted Drug Delivery Systems

Innovations in drug delivery aim to improve the efficacy of ulcer medications by targeting them more precisely to affected areas of the digestive tract.

Gene Therapy

Researchers are exploring genetic approaches to enhance the body’s natural defenses against ulcer-causing factors.

Personalized Treatment Plans

Advances in genetic testing and biomarker analysis may lead to more individualized treatment strategies for peptic ulcer disease.

These developments hold promise for more effective, tailored treatments for peptic ulcer disease in the future, potentially reducing the incidence of complications and improving patient outcomes.

Diagnosis of Peptic Ulcers (Stomach or Duodenal Ulcers)

How do doctors diagnose a peptic ulcer?

Your doctor may ask you about your medical and family history, perform a physical exam, and order tests to diagnose a peptic ulcer, find its cause, and check for complications.

Medical and family history

To help diagnose peptic ulcers and check for factors that cause ulcers, your doctor will take a medical and family history. Your doctor may ask about

• your symptoms
• your medical history, including any past peptic ulcers or Helicobacter pylori (H. pylori) infections
• medicines you take, especially nonsteroidal anti-inflammatory drugs (NSAIDs)
• your family history of peptic ulcers, H. pylori infection, or cancer in the digestive tract

To help diagnose a peptic ulcer, your doctor will take a medical and family history.

Physical exam

A physical exam may help a doctor diagnose peptic ulcers or ulcer complications. During a physical exam, a doctor most often

• checks for swelling in your abdomen
• listens to sounds within your abdomen using a stethoscope
• taps on your abdomen checking for tenderness or pain

What tests do doctors use to diagnose peptic ulcers?

Doctors may order medical tests to help diagnose peptic ulcers, find the cause, and check for complications.

Blood test

Doctors may use blood tests to check for signs of H. pylori infection or complications of peptic ulcers. For a blood test, a health care professional will take a blood sample from you and send the sample to a lab.

Urea breath test

Doctors may use a urea breath test to check for H. pylori infection. For the test, you will swallow a capsule, liquid, or pudding that contains urea “labeled” with a special carbon atom. If H. pylori is present, the bacteria will convert the urea into carbon dioxide. After a few minutes, you will breathe into a container, exhaling carbon dioxide.

A health care professional will test your exhaled breath. If the test detects the labeled carbon atoms, the health care professional will confirm an H. pylori infection in your digestive tract.

Stool test

Doctors may use stool tests to check for H. pylori infection. Your doctor will give you a container for catching and holding a stool sample. You will receive instructions on where to send or take the kit for testing.

Upper gastrointestinal (GI) endoscopy and biopsy

Doctors may order an upper GI endoscopy to confirm the diagnosis of a peptic ulcer and try to find its cause.

For an upper GI endoscopy, a doctor uses an endoscope—a flexible tube with a camera—to see the lining of your upper GI tract, including your esophagus, stomach, and duodenum. During upper GI endoscopy, a doctor obtains biopsies by passing an instrument through the endoscope to take small pieces of tissue from your stomach lining. A pathologist will examine the tissue under a microscope.

Upper GI series

In some cases, doctors may order an upper GI series to help diagnose peptic ulcers or ulcer complications. Upper GI series uses x-rays and a chalky liquid you swallow called barium to view your upper GI tract.

Peptic Ulcer Disease | Johns Hopkins Medicine

A peptic ulcer is an open sore found on the lining of the stomach or duodenum (the first part of the small intestine).

A gastric ulcer is located in the lining of the stomach.

A: X-ray of gastric ulcer in the antrum; B: Corresponding illustration of a gastric ulcer

A duodenal ulcer is located in lining of the duodenum.

A: Duodenal ulcer; B: Corresponding x-ray

Peptic Ulcer Disease Symptoms

Symptoms of peptic ulcer disease may be similar to other upper gastrointestinal conditions. Symptoms include:

• Abdominal discomfort or pain
• Nausea
• Pain radiating to the back (which could indicate the ulcer has penetrated)
• Burning or gnawing feeling similar to hunger pains
• Pain aggravated by meals (may suggest gastric ulcers)
• Pain relieved by meals (may suggest duodenal ulcers)

Because the symptoms of peptic ulcer disease are often nonspecific, it is important that you see a gastroenterologist for diagnosis.

Peptic ulcers; A: Malignant; B: Benign

Peptic Ulcer Disease Diagnosis

Diagnosis of peptic ulcer disease begins with a comprehensive physical exam. You will be asked about your symptoms and medical history.

Other diagnostic tests your doctor may order include:

• Barium contrast radiography
• Laboratory testing
• Gastrointestinal endoscopy

Barium Contrast Radiography

Barium contrast radiography (X-ray) or upper gastrointestinal (GI) series are specialized X-rays so your doctor can check for abnormalities.

During barium contrast radiography:

• You swallow a contrast solution called barium.
• The barium coats your esophagus and gastrointestinal tract, making it easier for the doctor to detect peptic ulcers.
• An X-ray is taken.

Barium X-ray does not offer a definitive diagnosis, as it does not distinguish between benign and malignant ulcers. In addition, the X-ray may be difficult to interpret in patients who had previous gastric surgery or scarring from chronic inflammation.

Laboratory Testing

Patients who do not respond to standard therapy for peptic ulcers may need specialized testing. If your symptoms do not improve after eight weeks of therapy, your doctor may want to order special tests. These include:

• Measuring serum gastrin and serum calcium: High levels of these hormones may indicate a more serious problem, such as:
  • Gastrinomas: Tumors associated with a rare gastroenterological disorder called Zollinger-Ellison syndrome
  • Multiple endocrine neoplasia (MEN): A disorder in which endocrine glands are overactive or form a tumor
• Testing for H. pylori infection. Your doctor may test for this in a number of ways:
  • Endoscopy with biopsy to obtain a tissue sample to test for the bacteria
  • Urea breath tests, a noninvasive method
  • Serologic testing, a blood test
  • Stool antigen, another noninvasive method of testing for H. pylori

Endoscopic Diagnosis

Your doctor may perform a gastrointestinal endoscopy with biopsy to diagnose peptic ulcer disease. A gastrointestinal endoscopy allows your doctor to examine the mucous lining of your upper gastrointestinal tract.

The endoscopy and biopsy are two parts of the same procedure:

• Endoscopy refers to the use of a flexible, lighted tube called an endoscope. Your doctor inserts the endoscope into your stomach through your mouth. The endoscope has a camera at the end so your doctor can see the inside of your body.
• Biopsy means your doctor removes a small tissue sample to send to a pathology lab for analysis.

During an upper endoscopy:

• You receive anesthesia and will be asleep during the procedure.
• You lie on your left side, referred to as the left lateral position.
• Your doctor inserts the endoscope through your mouth and pharynx into the esophagus.
• The endoscope transmits an image of the esophagus, stomach and duodenum to a monitor that your physician is watching.
• Biopsy forceps will be inserted into the endoscope to remove a tissue sample.

An esophagogastroduodenoscopy (EGD) is a specific endoscopy exam to diagnose peptic ulcer disease. This test can identify the ulcer, its location and size.

Ulcerative colitis – signs, symptoms, who treats, who treats

Ulcerative colitis is a type of inflammatory bowel disease. Ulcerative colitis occurs when the lining of the colon or rectum becomes inflamed. In this case, small ulcers form on the mucous membrane. The inflammation usually starts in the rectum and spreads upward. It can affect the entire colon. Inflammation causes the intestines to quickly move their contents and empty frequently. When cells on the surface of the intestinal mucosa die, ulcers form. Ulcers can cause bleeding, as well as mucus and pus.

Symptoms of ulcerative colitis

The severity of the symptoms of ulcerative colitis varies among patients with the disease. Symptoms can also change over time. Patients diagnosed with ulcerative colitis may experience periods of mild or no symptoms. This is called remission. General symptoms of knee disease:

• Abdominal pain
• Increased abdominal sounds
• Blood in stool
• Diarrhea
• Rectal pain
• Weight loss and malnutrition.

Ulcerative colitis can also cause additional symptoms:

• Joint pain
• Swelling of the joints
• Nausea and loss of appetite
• Skin problems
• Mouth ulcers
• Inflammation of the eyes.

What is the difference between ulcerative colitis and Crohn’s disease

Ulcerative colitis and Crohn’s disease are the most common forms of inflammatory bowel disease. Both conditions are thought to be the result of an overactive immune system. They also share many common symptoms, including:

• Convulsions
• Abdominal pain
• Diarrhea
• Fatigue.

However, ulcerative colitis and Crohn’s disease also have clear differences. Understanding the main differences between them ensures the correct diagnosis. First, these two conditions affect different parts of the gastrointestinal tract. Crohn’s disease can affect any part of the gastrointestinal tract, from the mouth to the anus. It is most often found in the small intestine. Ulcerative colitis only affects the colon and rectum. Similar medications are prescribed to treat both conditions. Surgery is also an effective option.

Causes of ulcerative colitis

Researchers believe that ulcerative colitis may be the result of an overactive immune system. However, it is not clear why some immune systems respond by attacking the colon while others do not. Factors that may play a role in the development of ulcerative colitis of the intestine:

• Genes. The patient may inherit a gene that increases the likelihood of developing ulcerative colitis
• Other immune disorders. If a patient has one type of immune disorder, they are more likely to develop a second
• Environmental factors. Bacteria, viruses and antigens can trigger the immune system.

Types of ulcerative colitis

Ulcerative colitis can be classified according to the affected parts of the gastrointestinal tract:

• Ulcerative proctitis. With ulcerative proctitis, only the rectum becomes inflamed. This is considered a mild form of ulcerative colitis
• Left-sided colitis. Causes inflammation in the area between the splenic flexure (near the upper colon) and the last section of the colon. The last section of the colon, known as the distal segment, includes the descending colon and the sigmoid colon. Left-sided colitis is also known as distal ulcerative colitis
• Proctosigmoiditis. Form of left-sided colitis. Causes inflammation of the rectum and sigmoid colon
• Extensive colitis. Known as pancolitis, it causes inflammation throughout the colon. This is considered a severe form of ulcerative colitis.

Ulcerative colitis in children

Children with inflammatory bowel disease are more likely to be diagnosed after 10 years of age. Symptoms of ulcerative colitis in children are similar to those in older patients. Children may experience bloody diarrhea, abdominal pain and cramps, and fatigue. Symptoms may be aggravated by certain factors:

• Anemia due to blood loss
• Malnutrition from malnutrition
• Unexplained weight loss.

Ulcerative colitis can have a significant impact on a child’s life, especially if the condition is not properly treated and controlled. Treatment of children is more limited due to possible complications. Medications may also be prescribed to reduce inflammation and prevent the immune system from attacking the colon. Some children may need surgery to correct symptoms.

Complications of ulcerative colitis

Ulcerative colitis increases the risk of colon cancer. The longer a patient has the disease, the higher the risk. Other complications of ulcerative colitis include:

• Thickening of the intestinal wall
• Intestinal bleeding
• Sepsis or blood poisoning
• Severe dehydration
• Toxic megacolon or rapidly swelling colon
• Colon rupture
• Inflammation of the skin, joints and eyes
• Ankylosing spondylitis, which involves inflammation of the joints between the bones of the spine
• Kidney stones
• Liver disease.

Complications of ulcerative colitis worsen if the condition is not properly treated.

Which doctor treats and diagnoses ulcerative colitis of the intestine

A gastroenterologist or proctologist deals with the diagnosis and treatment of ulcerative colitis. In the case of surgery, the treatment is carried out by the surgeon.

How a doctor diagnoses ulcerative colitis

Various tests can help a proctologist diagnose ulcerative colitis. The disease mimics other negative gut conditions such as Crohn’s disease. Your doctor will order several tests to rule out other conditions. Research protocol for the diagnosis of ulcerative colitis:

• Blood tests. A complete blood count looks for signs of anemia (low red blood cell count). Other studies point to inflammation, such as high levels of C-reactive protein and high sedimentation rates. The doctor can also order specialized tests for antibodies
• Examination of feces. Doctor examining stool for certain inflammatory markers, blood, bacteria, and parasites
• Computed colonoscopy
• Colonoscopy. During a colonoscopy, a doctor inserts a lighted endoscope, called a colonoscope, into the rectum to view the inside of the rectum
• Flexible sigmoidoscopy. It is a type of endoscopy. During this examination, the doctor inserts a long, flexible tube into the rectum to examine it, as well as the sigmoid colon and part of the descending colon.
• A biopsy in which a surgeon takes a sample of tissue from the colon for analysis.

Ulcerative colitis and colonoscopy

Doctors may use a colonoscopy to diagnose ulcerative colitis or determine the severity of the condition. Before the procedure, the doctor will most likely advise the patient to reduce the amount of solid food and switch to a liquid diet. Typical preparation for a colonoscopy also includes taking a laxative the night before the procedure because it is easier for doctors to examine a clean colon. During the procedure, the patient lies on his side. Your doctor will insert the colonoscope into your anus. This device is long and flexible so it can be easily moved around the gastrointestinal tract. During the examination, the doctor will look for signs of inflammation and check for precancerous growths called polyps. The doctor may also perform a biopsy.

If a patient is diagnosed with ulcerative colitis, the doctor may perform periodic colonoscopies to monitor inflammation, intestinal damage, and healing progress.

Colonoscopy is also an important diagnostic tool for colorectal cancer. If a patient has been diagnosed with ulcerative colitis, it is recommended to see a proctologist immediately if the following symptoms appear:

• Severe abdominal pain or cramps
• Severe rectal bleeding
• Chronic diarrhea difficult to treat
• High temperature
• Swelling of the skin or joints
• Dehydration.

These symptoms are sometimes associated with complications of ulcerative colitis.

Ulcerative Colitis Diet

There is no specific diet recommended for ulcerative colitis. Every patient reacts to food and drink differently. However, a few general rules may be helpful for patients trying to avoid flare-ups:

• Low fat diet. A low-fat diet is known to be beneficial, and high-fat foods commonly cause diarrhea, especially in patients with inflammatory bowel disease. Eating more low-fat foods may delay the onset of ulcerative colitis.
• Vitamin C intake. This vitamin may have a protective effect on the gut and help it recover faster from an ulcerative colitis flare-up. Patients on a diet rich in vitamin C have long periods of remission of ulcerative colitis.
• Increasing the amount of fiber in the diet. The use of fiber is recommended only during remission. It can also improve the process of removing waste during a bowel movement.

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Scientific sources:

1. Adler, G. Crohn’s disease and ulcerative colitis: per. with him. / G. Adler. M.: Geotar-Med, 2001. – 528 p.
2. Bereza M.N., Shamshonkova T.P., Yesterday N.N. Participation of immune mechanisms in the pathogenesis of nonspecific ulcerative colitis// Moscow Russian Journal of Gastroenterology, Hepatology, Coloproctology, 1996.-№4-S.289.-Ref.832.
3. Karpukhin O.Yu. Optimization of diagnostic methods and complex treatment of patients with nonspecific ulcerative colitis. Abstract diss. Dr. med. Sciences. Kazan, 2002. – 40 p.
4. Kirkin B.V., Rumyantsev V.G., Mikhailova T.L. Treatment of a severe attack of ulcerative colitis // Russian Journal of Gastroenterology, Hepatology, Coloproctology. 1993. – No. 3. – S. 67-70
5. Golofeevsky V.Yu., Gerasimov A.V., Sitkin S.I. Masevich index: a new approach to assessing the clinical and endoscopic activity of ulcerative colitis // Gastroenterology of St. Petersburg. 2004. – No. 1. – S. 14-15.

Useful information

Solitary rectal ulcer

Solitary rectal ulcer syndrome is a condition in which one or more open ulcers form in the rectum.

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Crohn’s disease

Crohn’s disease is a type of inflammatory bowel disease. Inflammation of the digestive tract can lead to abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition.

read more +

Pseudomembranous colitis

Pseudomembranous colitis, also called colitis C, is an inflammation of the colon associated with an overgrowth of the bacteria Clostridioides difficile.

read more +

Questions to the doctor about UC

We recommend that you see a proctologist or gastroenterologist if you have any symptoms of ulcerative colitis, such as blood in your stool or persistent changes in bowel function.
Before you see a specialist, we recommend that you prepare a list of questions to ask your doctor in advance. Here are some of them:

What to do before visiting a doctor.

• Be aware of any pre-appointments and restrictions . When you book your consultation, be sure to ask if there is anything you need to do beforehand, such as restricting your diet to reduce bloating.
• Write down in a notepad all the symptoms that you have, including any that you may not think are related to the reason you are seeing your doctor.
• Write down important personal information , including any recent major stress or recent changes in your life.
• Write down a list of all medications and any vitamins or supplements you take.
• Ask a family member or friend to come with you to for a consultation, if possible. Sometimes it can be difficult to understand all the information received during a doctor’s consultation. The person who accompanies you will help you remember what you missed or forgot.

Write down questions to ask the doctor.

Your time with your doctor is limited, so preparing a list of questions ahead of time will make your visit much more efficient. List your questions from most important to least important. Here are some basic questions we recommend you ask your doctor about Crohn’s disease:

• What causes the symptoms I am experiencing?
• Are there other possible causes for my symptoms?
• What examinations do I need? Do they require special training? Who will explain the test results to me?
• Is my condition temporary or permanent?
• What treatment do you recommend?
• How often do I need to have a colonoscopy?
• Are there any medications I should avoid?
• What side effects can be expected from the treatment?
• Will I be able to continue working at the same place or do I need to change working conditions?
• Are there any alternatives to the mainstream approach that you suggest?
• I have other diseases. How best to combine their treatment?
• Should dietary restrictions be observed?
• Are there risks for me or my baby from treatment if I am pregnant?
• What is the likelihood of my child developing UC if I have it?

In addition to the questions you have prepared for your doctor, feel free to ask any questions during your visit if you do not understand something.

What questions can the doctor ask?

Your doctor may ask you a number of questions. You need to be ready to answer them, this will help save time. Your doctor may ask:

• When did you get the symptoms you describe?
• Are your symptoms constant or intermittent?
• How severe are your symptoms?
• Do you suffer from abdominal pain? How often?
• Do you get diarrhea? How many times a day?
• Is there anything that reduces the intensity of symptoms?
• Is there anything that makes the symptoms worse?
• During what period of time and by how many kilograms did you lose weight? Was it intentional or not?
• Do you take non-steroidal anti-inflammatory drugs (ibuprofen, naproxen, diclofenac, etc.)?
• Have you ever had inflammatory diseases of the joints, eyes, rashes, mouth ulcers, skin sores?

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