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Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease that results from inappropriate activation of mucosal immune response of unknown etiology. It can occur at any age; however, it is most common in patients between 20 and 30 years of age. Both sexes are affected equally. Caucasians are more commonly affected. The incidence is 3 to 5 fold higher in Ashkenazi Jews as compared to the general population in the United States.

Geographically, the prevalence of UC is higher in North America, northern Europe, and Australia where there are higher levels of food hygiene and lower risk of food contamination. Parts of the world, including Asia, Africa, and South America where intestinal helminths and other parasitic infestations are endemic, the prevalence of inflammatory bowel disease is low.

The image shows a colectomy specimen with UC. Note the continuous involvement of the right half of the specimen and abrupt transition to normal mucosa. The affected mucosa is hyperemic and shows numerous pseudopolyps. For detailed gross pathologic features of UC, go to slides 6-15. Image copyright: pathorama.ch
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