الفهرس 
ACKNOWLEDGEMENT
Ulcerative ColitisOnly 14 pages are availabe for public view
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Abstract
One of the main problem facing patients with UC is flaring the disease that usually need intensive course of therapy with hospital admission. There are many reports about the role of enteric pathogens e.g., amoebiasis in the reactivation of the disease. This study aimed to assess the frequency of parasitic infestation in patients with ulcerative colitis and the role of E. histolytica infection on ulcerative colitis’s treatment response. A total of 30 patients with ulcerative colitis admitted to Al-Rajhi Liver Hospital, Assiut University Hospital, Egypt, were included in the study between July 2017 and July 2019. Of them, 11 (36.7%) patients had amoebiasis. All individuals were subjected to: Clinical history taking and examination. Laboratory investigation; complete blood picture, liver function tests, C- reactive protein and ESR. Stool analysis for the presence of parasites especially trophzoites or cysts ofE. histolytica and for detection of E. histolytica Ag by ELISA. Colonoscopy and assessment of the severity of ulcerative colitis by Mayo and partial Mayo scores. Patients who were positive for E. histolytica received single dose of 2 grams of secnidazole and response was evaluated by clinical assessment, stool analysis for detection of the parasite and endoscopic findings (in some cases) within 2 weeks The following results were observed: The frequency of amoebiasis in UC patients was 36.7%.Older age acquired higher frequency of amoebiasis where, the age of 45.5% of cases was more than 40 years. Patients with co-morbid diseases acquired significantly higher frequency of amoebiasis (9/11, 81.8%, P= 0.001) where liver disease was the frequent one. Regarding of clinical data, UC patients with amoebiasis had significantly more diarrheal attacks/day [5 (3-7) attacks] compared to those without amoebiasis [4 (3-6) attacks], (P = 0.026). Patients with amoebiasis had significantly more severe disease based upon Mayo and partial Mayo score compared with those without amoebiasis (P =0.043 and 0.023 respectively). On receiving the anti-amoebic treatment, patients with amoebiasis showed clinical improvement in the form of decrease daily diarrheal attacks, decrease blood in stool and improved their general condition with absence of the parasite in the stool and improvement of endoscopic findings in some cases. Significant improvement in the partial Mayo score in those patients receiving anti-amoebic treatment [pre-treatment score (7 ± 2) vs. post-treatment (4.5 ± 1.7), P < 0.001].