Ulcerative Colitis is a chronic inflammatory disease that belongs to the group of inflammatory bowel diseases (IBD), which is characterized by persistent inflammation of the mucosal lining of the colon only. The inflammation always involves the rectum and may spread continuously along the entire length of the colon, and in rare cases also to the terminal portion of the small intestine.

The disease causes the formation of ulcers and sores in the inner wall of the colon, and depending on the extent of inflammation, the severity of symptoms varies: abdominal pain, frequent diarrhea (sometimes with blood or pus), urgency of bowel movements, weight loss, fatigue, fever, and in some cases impaired growth in children.

The disease is characterized by periods of flare-ups and remission, and can manifest at any age but is most common between ages 15-30. The exact cause is unknown, but the hypotheses suggest a combination of genetic, environmental, and an excessive immune response against beneficial gut bacteria or foreign pathogens, leading to an uncontrolled inflammatory reaction. Ulcerative Colitis requires ongoing medication and usually also gastroenterological follow-up.

The medications are intended to suppress the inflammation and to regulate immune system activity. In severe cases and in the event of complications, surgery for partial or total removal of the colon may be required. There are currently about 21,000 people with Ulcerative Colitis in Israel, and in recent years the incidence has increased in Western countries.

Diagnostic tests include, among others, colonoscopy and blood tests, as well as a new video capsule test that enables full and non-invasive scanning of the colon to evaluate inflammation and monitor the disease.

An imaging test performed using CT that does not involve insertion of an endoscopic device through the entire colon. It enables identification of polyps or tumors, but does not allow for treatment or biopsy. Therefore, if a finding is detected, a complementary endoscopic examination is necessary.

For this reason, we do not perform this test and recommend undergoing endoscopic colonoscopy.

A weighted score calculated from the data, determining whether the reflux is pathological (disease-related) or within the normal range.

Zenker's Diverticulum is a pouch that forms at the junction between the pharynx and the upper esophagus. This condition causes food accumulation, bad breath, dysphagia, and regurgitation. The most advanced treatment today is the endoscopic division of the septum (Z-POEM) with no need for external neck incisions.

Z-POEM adapts the POEM tunneling technique to Zenker's diverticulum. A submucosal tunnel provides access to the cricopharyngeal muscle and permits controlled division of the septum.

Why is it important? The aim is to improve emptying of the pouch and relieve swallowing difficulty, regurgitation and cough related to retained food.

Diagnosis and treatment Evaluation commonly includes a barium swallow and endoscopic assessment. Suitability depends on pouch size, anatomy, symptom burden and the patient's overall condition.