[6][8] The removal of the appendix at an early age may be protective. Meist sind es Krankheiten an Knochen und Gelenken, der Augen und der Haut. Zellen innerhalb der Lymphknoten … Habe ich Corona oder doch "nur" einen Schnupfen? The medications used to induce and maintain a remission somewhat overlap, but the treatments are different. Pouchitis can be acute, remitting, or chronic however treatment using antibiotics, steroids, or biologics can be highly effective. In addition to autoimmune destruction, anemia may occur due to chronic blood loss from rectal bleeding and bone marrow suppression due to inflammation (anemia of chronic disease). [19] Moderate abdominal pain, low-grade fever, 38 to 39 °C (100 to 102 °F), and anemia may develop (75% of normal). Bei der Crohn’schen Krankheit erwarten Sie durchgehende Schmerzen im rechten Unterbauch, bei Colitis ulcerosa hingegen meistens beim Stuhlgang oder kurz davor, und dann auch eher im linken Unterbauch. [14], While the ileal pouch procedure removes the need for an ostomy bag, it does not restore normal bowel function. Bei Patienten mit Colitis ulcerosa müssen die Vorsorgeuntersuchungen deutlich früher begonnen und häufiger durchgeführt werden. [51] High intake of unsaturated fat and vitamin B6 may enhance the risk of developing ulcerative colitis. [2] The first description of ulcerative colitis occurred around the 1850s. [19] Antibodies against Saccharomyces cerevisiae may be present, but are more often positive in Crohn's disease compared with ulcerative colitis. About 8% of individuals with UC develop oral manifestations. [1] Weight loss, fever, and anemia may also occur. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 10th edition, 2016. eds Mark Feldman, Lawrence S. Friedman, Lawrence J. Brandt. (b) Nach Gabe von Kontrastmittel i.v. Thus, the drug may locally decrease histamine secretion by involved gastrointestinal mast cells and alleviate the inflammation.[152]. Some advise that parenteral iron be used first because people respond to it more quickly, it is associated with fewer gastrointestinal side effects, and it is not associated with compliance issues. Ulcerative colitis (UC) is a long-term condition that results in inflammation and ulcers of the colon and rectum. [118] Other studies found a benefit from using fecal microbiota transplantation. Im Vergleich zu anderen Webseiten ist vielleicht nicht alles so perfekt, aber wir gehen Chronic bleeding from the GI tract, chronic inflammation, and iron deficiency often leads to anemia, which can affect quality of life. Both helminthic therapy and fecal microbiota transplant induce a characteristic Th2 white cell response in the diseased areas, which was unexpected given that ulcerative colitis was thought to involve Th2 overproduction. [91][92] Rectal suppository, foam or liquid enema formulations of 5-ASA are used for colitis affecting the rectum, sigmoid or descending colon, and have been shown to be effective especially when combined with oral treatment. Colitis ulcerosa: die befallenen Kolonabschnitte lassen sich meist sehr gut auffinden. Lymphknoten sind Filterstationen für die Lymphe (Gewebewasser), die ständig aus den Blutkapillaren in das Gewebe austritt und über Lymphgefäße wieder in den Blutkreislauf zurücktransportiert wird. [30] Inflammation may also involve the white part of the eye (sclera) or the overlying connective tissue (episclera), causing conditions called scleritis and episcleritis. [13] With proctitis (inflammation of the rectum), people with UC may experience urgency or rectal tenesmus, which is the urgent desire to evacuate the bowels but with the passage of little stool. Doch nicht immer lassen die Symptome von Colitis ulcerosa eindeutig auf eine Störung des Verdauungssystems schließen. Colitis ulcerosa betrifft vor allem das Rektum und ist häufig von Schmerzen im linken Unterbauch begleitet. People 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. [19] Fecal calprotectin is 88% sensitive and 79% specific for the diagnosis of ulcerative colitis. [29] The two most common oral manifestations are aphthous stomatitis and angular cheilitis. This involves removing the large majority of the remaining rectal stump and creating a new "rectum" by fashioning the end of the small intestine into a pouch and attaching it to the anus. Menschen mit einer Colitis ulcerosa leiden typischerweise unter blutig-schleimigen Durchfällen. Die Darmerkrankung Colitis ulcerosa hat oft Begleiterkrankungen wie Arthritis und Osteoporose. [117], Fecal microbiota transplant involves the infusion of human probiotics through fecal enemas. [42] Some of the putative regions encode transporter proteins such as OCTN1 and OCTN2. Bei adipösen Bauchdecken wird man eher mit einem 5- oder 7,5 MHz-Schallkopf zurecht kommen, bei schlanken Personen bietet der 10- oder 12-MHz-Schallkopf Vorteile. [13], A complete blood count may demonstrate anemia, leukocytosis, or thrombocytosis. [13] A substantial proportion (up to 45%) of people with a history of UC without any ongoing symptoms (clinical remission) have objective evidence of ongoing inflammation. Das Risiko, an Darmkrebs (Kolonkarzinom) zu erkranken, ist bei Patienten mit Colitis ulcerosa gegenüber der Normalbevölkerung erhöht. Crohn und Colitis ulcerosa gezählt. [5] The peak onset is between 30 and 40 years of age,[13] with a second peak of onset occurring in the 6th decade of life. Das hat damit zu tun, dass die Colitis ulcerosa mit bestimmten Komplikationen einhergehen kann, die potentiell lebensbedrohlich verlaufen können und somit einen Einfluss auf die Lebenserwartung haben. [9] Each year it newly occurs in 1 to 20 per 100,000 people, and 5 to 500 per 100,000 individuals are affected. perinuclear antineutrophil cytoplasmic antibodies, decreased ability of the immune system to clear infections, List of people diagnosed with ulcerative colitis, "Predictive factors for a severe clinical course in ulcerative colitis: Results from population-based studies", "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015", "Promising biological therapies for ulcerative colitis: A review of the literature", "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015", internetmedicin.se > Inflammatorisk tarmsjukdom, kronisk, IBD, "Management of Crohn's disease in adults", "Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. In fact, this linkage on chromosome 6 may be the most convincing and consistent of the genetic candidates. Bloody diarrhea and abdominal pain may be more prominent features in severe disease. Auch das Darmkrebsrisiko hängt damit zusammen, wie stark die Darmwand durch die Erkrankung geschädigt wurde. Nun hat eine Studie der Berliner Charité die Wirksamkeit von Myrrhe bei chronisch-entzündlichen Darmerkrankungen untersucht und belegt. Anemia may be due to a complication of treatment from azathioprine, which can cause low blood counts,[69] or sulfasalazine, which can result in folate deficiency. Colitis ulcerosa … [131], The first description of ulcerative colitis occurred around the 1850s. Beide Erkrankungen treten chronisch-rezidiv auf. The form in which treatment is administered depends both on the severity of the anemia and on the guidelines that are followed. This procedure is necessary in the event of: exsanguinating hemorrhage, frank perforation, or documented or strongly suspected carcinoma. This so-called "backwash ileitis" can occur in 10–20% of people with pancolitis and is believed to be of little clinical significance.[22]. Oft treten auch Störungen … Blutige, häufig auch mit Schleim versetzte Durchfälle halten Experten für das Hauptsymptom. Das heißt, dass sie die meisten Betroffenen ein Leben lang begleitet. In addition to the extent of involvement, UC is also characterized by severity of disease. In the months following the final operation, patients typically experience 8–15 bowel movements a day. Sometimes, these associated extra-intestinal symptoms are the initial signs of the disease. [116] A probiotic called VSL#3 may be effective in inducing remission in active ulcerative colitis, and may may be as effective as 5-ASAs in preventing relapse of quiescent UC. ‚Makrophagen‘) nehmen diese Gefahrenquellen auf und versuchen sie unschädlich zu machen. If the serous membrane is involved, a colonic perforation may ensue. [33] The immune system may attack the red blood cells, leading to autoimmune hemolytic anemia. Patienten mit Colitis ulcerosa haben aus medizinischer Sicht keine wesentliche Einschränkung der Lebenserwartung zu befürchten. Ein großer Unterschied aber ist, dass bei Colitis ulcerosa nur Enddarm und eventuell Dickdarm entzündet sind, während Morbus Crohn den gesamten Verdauungstrakt (vom Mund bis zum After) betreffen kann. [1] Theories involve immune system dysfunction, genetics, changes in the normal gut bacteria, and environmental factors. [72], The most common disease that mimics the symptoms of ulcerative colitis is Crohn's disease, as both are inflammatory bowel diseases that can affect the colon with similar symptoms. Initially, a flexible sigmoidoscopy may be completed to establish the diagnosis. Hier geht´s direkt zum Test: Wie hoch ist meine Infektionsrisiko? Die Patienten müssen tagsüber und nachts häufig ihren Darm entleeren. [15], The clinical presentation of ulcerative colitis depends on the extent of the disease process. Die Frequenz der Schübe ist ein Indikator für die Aktivität der Erkrankung. Es gibt Patienten, die nach einem Schub jahrelang ohne Beschwerden leben. [148], Neutrophil extracellular traps[149] and the resulting degradation of the extracellular matrix[150] have been reported in the colon mucosa in ulcerative colitis patients in clinical remission, indicating the involvement of the innate immune system in the etiology. [112], Another surgical option for ulcerative colitis that is affecting most of the large bowel is called the ileal pouch-anal anastomosis (IPAA). Zusätzlich können kolikartige (krampfartige) Bauchschmerzen bestehen, die je nach Befall des Darms in den vers… Bei Patienten mit chronisch entzündlichen Darmerkrankungen (Morbus Crohn, Colitis ulcerosa) soll eine langfristige systemische Corticosteroidtherapie als Rezidivprophylaxe nicht durchgeführt werden. Filterstation: Im lymphatischen System, also dem System bestehend aus Lymphknoten, Lymphgefäßen und Lymphe, haben die Lymphknoten eine Filterfunktion für Bakterien, Viren, Krebszellen und andere Fremdkörper. Leiden Sie an einer Colitis ulcerosa?Beantworten Sie dazu 10 kurze Fragen und erfahren Sie mögliche Ursachen, sowie Therapiemöglichkeitens. Depending on the severity of the condition, pouch revision surgery may need to be performed. Bei Patienten, bei denen nicht klar zwischen Morbus Crohn und Colitis ulcerosa unter-schieden werden kann, nennt man die entzündliche Darm-krankheit Colitis … So klagen zahlreiche Patienten über schmerzende Gelenke oder Hautentzündungen. [130] However, the distribution of causes-of-death differs from the general population. Time taken between each step can vary, but typically a six- to twelve-month interval is recommended between the first two steps, and a minimum of two to three months is required between the formation of the pouch and the ileostomy take-down. Hier geht´s direkt zum Test: Corona oder Erkältung? Wie wird 5-ASA bei der Colitis ulcerosa eingenommen? Bei Patienten, bei denen nicht klar zwischen Morbus Crohn und Colitis ulcerosa unter-schieden werden kann, nennt man die entzündliche Darm-krankheit Colitis indeterminata. Perianal disease is rare. Sie tritt gehäuft als Begleiterkrankung der Colitis ulcerosa auf. 2. When done in two steps, a proctocolectomy – removing both the colon and rectum – is performed alongside the pouch formation and loop ileostomy. Colitis ulcerosa ist eine chronisch verlaufende Krankheit, bei der sich gesunde Phasen mit Krankheitsschüben abwechseln. [59], Infection by mycobacterium avium, subspecies paratuberculosis, has been proposed as the ultimate cause of both ulcerative colitis and Crohn's disease. Breitet sich die Entzündung aus, können die Durchfälle häufiger auftreten und schlimmer werden. [98][99] In select individuals with a history of previous tobacco use, resuming low dose smoking may improve signs and symptoms of active ulcerative colitis. [67] The physician may elect to limit the extent of the initial exam if severe colitis is encountered to minimize the risk of perforation of the colon. Diagnostik und Therapie von chronisch-entzündliche Darmerkrankungen (M. Crohn, Colitis ulcerosa). Auch bei chronisch-entzündlichen Darmerkrankungen mit extraintestinalen Symptomen, zum Beispiel Colitis ulcerosa und Morbus Crohn, bei hämatologischen Störungen wie Agranulozytose oder Non-Hodgkin-Lymphom können Aphthen auftreten. Die Phasen der Entzündung der Darmschleimhaut werden als Schub bezeichnet. [126] Several risk factors are associated with eventual need for colectomy, including: prior hospitalization for UC, extensive colitis, need for systemic steroids, young age at diagnosis, low serum albumin, elevated inflammatory markers (CRP & ESR), and severe inflammation seen during colonoscopy. Informieren Sie sich hier, welche Anzeichen zu Beginn der … Infliximab or vedolizumab are recommended in those with moderate or severe disease. Zellen innerhalb der Lymphknoten (sog. … Die Colitis ulcerosa gehört wie auch der Morbus Crohn und die Kollagene Kolitis zur Gruppe der chronisch-entzündlichen Darmerkrankungen (CED). Werden die regelmäßigen Vorsorgekoloskopien nicht in Anspruch genommen, besteht ein überdurchschnittlich hohes Risiko, dass der Darmkrebs erst in einem fortgeschritten Stadium diagnostiziert wird. Die Erkrankung äußert sich in der Regel mit blutig-schleimigen Diarrhoen, die von Tenesmen und kolikartigen Bauchschmerzen begleitet sein können. [101] In one double-blind, placebo-controlled study conducted in the United Kingdom, 48.6% of people with UC who used the nicotine patch, in conjunction with their standard treatment, showed complete resolution of symptoms. Osteoporosis may occur related to systemic inflammation, which increases the risk of bone fractures. The second step is a proctecomy and formation of the ileal pouch (commonly known as a "j-pouch"). [151][152] Opportunely, low gastrointestinal absorption (or high absorbed drug gastrointestinal secretion) of fexofenadine results in higher concentration at the site of inflammation. [90] Many 5-ASA drugs have been developed with the aim of delivering the active compound to the large intestine to maintain therapeutic efficacy but with reduction of the side effects associated with the sulfapyridine moiety in sulfasalazine. [78], For acute stages of the disease, a low fiber diet may be recommended. [157], Inflammatory bowel disease that causes ulcers in the colon, Extraintestinal manifestations and complications, CS1 maint: DOI inactive as of January 2021 (. [32] As many as 5% of people with ulcerative colitis may progress to develop primary sclerosing cholangitis. Welchen Einfluss hat das Entartungsrisiko auf die Lebenserwartung? [18], Ulcerative colitis has a significant association with primary sclerosing cholangitis (PSC), a progressive inflammatory disorder of small and large bile ducts. The response of ulcerative colitis is potentially very favorable with one study reporting 67.7% of sufferers experiencing complete remission. [citation needed], UC may cause high levels of inflammation throughout the body, which may be quantified with serum inflammatory markers, such as CRP and ESR. [100] Studies using a transdermal nicotine patch have shown clinical and histological improvement. However, a complete colonoscopy with entry into the terminal ileum should be performed to rule out Crohn's disease, and assess extent and severity of disease. Eine Proctitis ulcerosa ist transabdominell nicht erfassbar. Ulcerative colitis may improve and enter remission. "[20], The disease is classified by the extent of involvement, depending on how far the disease extends:[14] proctitis (rectal inflammation), left sided colitis (inflammation extending to descending colon), and extensive colitis (inflammation proximal to the descending colon). [50], As the colon is exposed to many dietary substances which may encourage inflammation, dietary factors have been hypothesized to play a role in the pathogenesis of both ulcerative colitis and Crohn's disease. Moderate to severe disease correlates with more than six stools daily, frequent bloody stools and urgency. [19], The risk of colorectal cancer is significantly increased in people with ulcerative colitis after ten years if involvement is beyond the splenic flexure. When present, ulcerations may be confluent. Other possible … [9] Each year, ulcerative colitis newly occurs in 1 to 20 per 100,000 people (incidence), and there are a total of 5-500 per 100,000 individuals with the disease (prevalence). [147], A series of drugs in development looks to disrupt the inflammation process by selectively targeting an ion channel in the inflammation signaling cascade known as KCa3.1. Die Colitis ulcerosa zählt zu den chronisch-entzündlichen Darmerkrankungen. Das bedeutet also, dass Patienten mit häufigen starken Schüben ein höheres Komplikationsrisiko haben als Patienten mit seltenen Schüben und niedriger Krankheitsaktivität. [52] Other identified dietary factors that may influence the development and/or relapse of the disease include meat protein and alcoholic beverages. [129] Specific risk factors may predict worse outcomes and a higher risk of mortality in people with ulcerative colitis, including: C. difficile infection[19] and cytomegalovirus infection (due to reactivation). Specifically, perinuclear antineutrophil cytoplasmic antibodies (pANCA) are found in 70 percent of cases of UC. Die medikamentöse Therapie hat daher einen entscheidenden Einfluss auf das Komplikationsrisiko der Colitis ulcerosa. A few cases have been misdiagnosed as UC with poor outcomes occurring due to the use of corticosteroids. In addition, inflammatory markers are not uniformly elevated in people with ulcerative colitis. Neben Heidelbeeren, Aroniabeeren und Schwarzkümmelöl ist ja auch schon länger Myrrhe im Gespräch. Ulcerative Colitis, Chapter 116, pp.2023–2061. Part 1: Definitions, Diagnosis, Extra-intestinal Manifestations, Pregnancy, Cancer Surveillance, Surgery, and Ileo-anal Pouch Disorders", "Iron deficiency anemia in inflammatory bowel disease", "Predictors of endoscopic inflammation in patients with ulcerative colitis in clinical remission", "ACG Clinical Guideline: Ulcerative Colitis in Adults", "Crohn Disease: Epidemiology, Diagnosis, and Management", "Extraintestinal Manifestations of Inflammatory Bowel Disease", "Oral pathology in inflammatory bowel disease", "Ophthalmic manifestations in patients with inflammatory bowel disease: A review", "Current trends in inflammatory bowel disease: the natural history", "Venous thromboembolism in inflammatory bowel disease", "Risk of thrombosis and mortality in inflammatory bowel disease", "Targeting improves MSC treatment of inflammatory bowel disease", "Ulcerative colitis and Crohn's disease in an unselected population of monozygotic and dizygotic twins. Curcumin (turmeric) therapy, in conjunction with taking the medications mesalamine or sulfasalazine, may be effective and safe for maintaining remission in people with quiescent ulcerative colitis. The goal is to induce remission initially with medications, followed by the administration of maintenance medications to prevent a relapse. Vergrößerte retroperitoneale Lymphknoten bei Non-Hodgkin Lymphom, die sich vom Oberbauch bis in die rechte Leiste verfolgen lassen (hochfrequenter Linearschallkopf) Malignitätssuspekter Lymphknoten dorsal … [8] In general, higher rates are seen in northern locations compared to southern locations in Europe[135] and the United States. [14], The removal of the entire large intestine, known as a proctocolectomy, results in a permanent ileostomy – where a stoma is created by pulling the terminal ileum through the abdomen. Die Erkrankung beginnt jedoch nicht immer schleichend: Sie … [32], UC may cause several joint manifestations, including a type of rheumatologic disease known as seronegative arthritis, which may affect few large joints (oligoarthritis), the vertebra (ankylosing spondylitis) or several small joints of the hands and feet (peripheral arthritis). Pancolitis describes involvement of the entire colon, extending from the rectum to the cecum. “ulcerative colitis”) gehört zu den sogenannten chronisch entzündlichen Darmerkrankungen (CED). Hier geht's direkt zum Test Colitis ulcerosa. Hinzu kommen Fieber, Erschöpfung, mitunter auch Augenentzündungen, Hautveränderungen und geschwollene Gelenke. In der Regel werden Schallköpfe mit 5 bis 12 MHz zur Untersuchung verwendet. [16] Up to 15% of individuals may have severe disease upon initial onset of symptoms. Andere Patienten, haben sehr häufige Schübe. Few studies have investigated such an association; one study showed no association of refined sugar on the number of people affected of ulcerative colitis. Inflammation may occur in the interior portion of the eye, leading to uveitis and iritis. [81][19] Surgical removal of the large intestine is necessary in some cases. [26][36] PSC is more common in men, and often onsets between 30 and 40 years of age. The concept of induction of remission and maintenance of remission is very important. Dabei steigt das Darmkrebsrisiko exponentiell mit der Krankheitsdauer an. [107] Others require oral iron to be used first, as people eventually respond and many will tolerate the side effects. Häufig findet man vermehrt weiße Blutkörperchen (Lymphozyten) im Blut und die Lymphknoten … Sie kann jedoch jederzeit wieder ausbrechen. Ulcerative colitis is an autoimmune disease characterized by T-cells infiltrating the colon. Ultraschall-Untersuchungen Bauchorgane, Gefäße, Schilddrüse, Lymphknoten… Die Diarrhoe kann sehr stark, bis zu 30-mal am Tag, oder so gut wie gar nicht auftreten, wenn zum Beispiel nur der After betroffen ist (Proktitis). Andere Bezeichnung für Colitis ulcerosa: Chronisch entzündliche Darmerkrankung. Darmkrebsvorsorgeuntersuchungen müssen auch bei medikamentös optimal  eingestellten Patienten ab einer bestimmten Krankheitsdauer regelmäßig durchgeführt werden. Dieser Frage soll in den nachfolgenden Abschnitten genauer auf den Grund gegangen werden. Hier geht´s direkt zum Test: Gehöre ich zur Coronavirus-Risikogruppe? [79][80], Ulcerative colitis can be treated with a number of medications, including 5-ASA drugs such as sulfasalazine and mesalazine. Dies verdeutlicht die große und wichtige Rolle der Darmkrebsvorsorge (Vorsorge-Koloskopie) bei Patienten mit Colitis ulcerosa. Welchen Einfluss haben die Schübe auf die Lebenserwartung? Commonly affected organs include: eyes, joints, skin, and liver. Twenty five percent of individuals with confirmed inflammation on endoscopic evaluation have a normal CRP level. [53][54] Specifically, sulfur has been investigated as being involved in the cause of ulcerative colitis, but this is controversial. In 1977, it was shown that 5-aminosalicylic acid (5-ASA, mesalazine/mesalamine) was the therapeutically active component in sulfasalazine. ", "paratuberculosis cause Crohn's disease, ulcerative colitis…and colorectal cancer? Hier geht´s direkt zum Test: Colitis Ulcerosa. [113][114], The risk of cancer arising from a ileal pouch anal anastaomosis is low. [19] Severity of disease is defined by symptoms, objective markers of inflammation (endoscopic findings, blood tests), disease course, and the impact of the disease on day-to-day life. Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD)", "East-West gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort", Centers for Disease Control and Prevention, "Adhesion molecules in inflammatory bowel disease", "A phase II dose ranging, double-blind, placebo-controlled study of alicaforsen enema in subjects with acute exacerbation of mild to moderate left-sided ulcerative colitis", "Systematic review of randomized controlled trials of probiotics, prebiotics, and synbiotics in inflammatory bowel disease", "NS6180, a new K(Ca) 3.1 channel inhibitor prevents T-cell activation and inflammation in a rat model of inflammatory bowel disease", "Neutrophil Extracellular Traps in Ulcerative Colitis: A Proteome Analysis of Intestinal Biopsies", "Degradation of the extracellular matrix is part of the pathology of ulcerative colitis", "Etrolizumab as induction therapy for ulcerative colitis: a randomised, controlled, phase 2 trial", Esophageal intramural pseudodiverticulosis, Small bowel bacterial overgrowth syndrome, Crohn's and Colitis Foundation of America, National Society for Colitis and Crohn's Disease, List of people diagnosed with Crohn's disease, https://en.wikipedia.org/w/index.php?title=Ulcerative_colitis&oldid=1001321835, Steroid-responsive inflammatory conditions, CS1 maint: DOI inactive as of January 2021, Articles containing potentially dated statements from 2015, All articles containing potentially dated statements, Articles with unsourced statements from October 2020, Articles containing potentially dated statements from 2004, All articles with vague or ambiguous time, Vague or ambiguous time from December 2019, Wikipedia medicine articles ready to translate, Creative Commons Attribution-ShareAlike License, Patchy areas of inflammation (skip lesions), Deep geographic and serpiginous (snake-like), Lower endoscopy to evaluate the rectum and distal large intestine (, This page was last edited on 19 January 2021, at 05:19.