Clinical Course Of Ulcerative Colitis Research Articles

Continous oral plus topical 5-ASA administration significantly modifies the clinical course of ulcerative colitis

Continous oral plus topical 5-ASA administration significantly modifies the clinical course of ulcerative colitis

Continous oral plus topical 5-ASA administration significantly modifies the clinical course of ulcerative colitis

Continous oral plus topical 5-ASA administration significantly modifies the clinical course of ulcerative colitis

Minor differences in first manifestation and first-year clinical course of ulcerative colitis between younger and older patients

Minor differences in first manifestation and first-year clinical course of ulcerative colitis between younger and older patients

Appendectomy protects against the development of ulcerative colitis and reduces its recurrence: results of a multicenter case-controlled study in Japan

OBJECTIVES: Studies in the US and Europe have shown that appendectomy may prevent the development of ulcerative colitis, but no detailed study has been conducted in Japan, where ulcerative colitis is uncommon and the population is racially homogeneous. In addition, there has been no detailed analysis of the relationship between appendectomy and the clinical course of ulcerative colitis. In this multicenter clinical study, we evaluated the effects of appendectomy on ulcerative colitis in Japan. METHODS: A case-control study was undertaken in seven medical institutions comparing the incidence of appendectomy and tonsillectomy in 325 patients with ulcerative colitis and 325 controls matched for age (10-yr intervals) and sex. Disease duration, extent, and prognosis were determined in 21 patients with ulcerative colitis who underwent appendectomies and 304 patients with ulcerative colitis who did not undergo appendectomies. RESULTS: Appendectomy was performed in a significantly lower percentage of patients in the ulcerative colitis group (21/325, 6.5%) than in the control group (53/325, 16.3%) ( p < 0.001) (odds ratios = 0.355, 95% CI = 0.208–0.603). In contrast, no significant difference was observed between the groups with respect to tonsillectomy. The mean age (25.7 ± 10.9 yr) of patients with ulcerative colitis at the time of appendectomy was significantly higher than the mean age (20.1 ± 8.7 yr) of patients in the control group at the time of appendectomy ( p < 0.05). The incidence of proctitis was higher in the appendectomy group than in the group that did not undergo appendectomies (38.1% vs 18.1%). In addition, the recurrence rates were significantly lower in the appendectomy group than in the group that did not undergo appendectomies (57.1% vs 78.6%, p < 0.05), although both groups were similar in composition as to sex, age, duration of disease, smoking status, and previous medical treatment. CONCLUSIONS: Our results indicate that appendectomy has a negative association with and perhaps a preventive effect on the development of ulcerative colitis in the Japanese population. Furthermore, appendectomy also appears to reduce the extent and recurrence of ulcerative colitis.

Minor differences in first manifestation and first-year clinical course of ulcerative colitis between younger and older patients

Minor differences in first manifestation and first-year clinical course of ulcerative colitis between younger and older patients

Reduced Plasma Antioxidant Concentrations and Increased Oxidative DNA Damage in Inflammatory Bowel Disease

Background: Oxidative stress is believed to play a key role in the pathogenesis of inflammatory bowel disease (IBD)-related intestinal damage. Circulating antioxidants may have a role to play in preventing free radical-mediated tissue injury. Methods: Plasma vitamin A, E and carotenoid concentrations, leukocytic genomic damage and 8-hydroxy-deoxy-guanosine (8-OHdG) concentration were determined in 46 ulcerative colitis (UC) patients, 37 Crohn disease (CD) patients and 386 controls. A 20 ml blood sample was taken from each subject for antioxidant and 8-OHdG measurements. A food frequency questionnaire was administered to a sample of subjects from each group to evaluate daily intake of dietary compounds. Results: Antioxidant concentration was significantly reduced in IBD patients, particularly in those with active disease, with respect to controls ( P < 0.0001). 8-OHdG concentrations were significantly increased in IBD patients compared to controls, independent of disease activity ( P < 0.05). No correlation was found between antioxidant and 8-OHdG concentrations. Carotenoid concentrations were significantly reduced in malnourished IBD patients (0.89 ± 0.14 μmol/l) compared to patients with normal or high body mass index (1.83 ± 0.12 μmol/l; P < 0.05), independent of disease activity or extension. Protein, fruit and vegetable intakes of IBD patients were significantly lower than those of controls. Conclusions: Depletion of antioxidants is likely to be important in the pathophysiology of IBD: UC and CD patients show increased free radical peripheral leukocyte DNA damage and decreased plasma antioxidant defenses. These results indicate the necessity of further studies to establish whether optimal vitamin status may improve the clinical course of UC and CD.

Serum anti-P53 antibodies seem to be related to clinical course of ulcerative colitis

Serum anti-P53 antibodies seem to be related to clinical course of ulcerative colitis

Effects of smoking on the presentation and clinical course of inflammatory bowel disease.

To evaluate the influence of regular smoking on the presentation and clinical course of inflammatory bowel disease. We performed a case-control study interviewing 160 inflammatory bowel disease patients (63 with Crohn's disease (CD) and 97 with ulcerative colitis (UC)) and 140 first-degree relatives as controls. The risk of developing the disease relative to a smoking habit was calculated as the odds ratio. Furthermore, to evaluate the influence of smoking on the subsequent course of inflammatory bowel disease, we performed a multivariate analysis that included pertinent variables such as the need for surgery, number of hospitalizations and relapses. The pattern of smoking in UC patients was different from that in CD patients. In UC there was a significant predominance of non-smokers and ex-smokers (P = 0.02), whereas smoking habits in CD were not different from those in controls. Giving up smoking was a risk factor to develop UC (odds ratio: 3.2, P = 0.02). In UC, non-smokers and specially ex-smokers need surgery more frequently than smokers (P < 0.01). Otherwise the relapse/year index was not influenced by smoking. In CD there was a non-significant association between smoking habits and the various clinical parameters analysed. UC patients who begin smoking after diagnosis of the disease present a significant reduction in the number of recurrences. Smoking habit significantly affects the presentation and clinical course of UC, whereas in CD, a smoking habit does not have any apparent influence on the disease.

Effects of cigarette smoking on the clinical course of ulcerative colitis.

We assessed the effect of smoking on the clinical course of ulcerative colitis in 209 subjects by comparing disease severity in smokers and non-smokers as measured by yearly number of hospitalizations for ulcerative colitis treatment and the need for a colectomy. Hospitalization for ulcerative colitis treatment occurred less frequently in persons who smoked after disease onset, but the colectomy rate in persons who smoked after disease onset and non-smokers was similar. Both hospitalization and colectomy for treatment of ulcerative colitis occurred more frequently among smokers who quit before disease onset. Furthermore, hospitalization and colectomy occurred most frequently in the heaviest smokers who quit before disease onset. We found no strong evidence of a therapeutic effect of smoking after ulcerative colitis onset on this illness's clinical course, but smoking before disease onset may affect the clinical severity of this illness.

Geographical Differences in Diagnosis or in Clinical Course of Ulcerative Colitis?

Geographical Differences in Diagnosis or in Clinical Course of Ulcerative Colitis?

Ulcerative Colitis in the Jewish Population of Tel-Aviv Yafo III. Clinical Course

The clinical course of ulcerative colitis has been studied and analyzed in 504 Jewish patients in the Tel Aviv area. The length of follow-up was 1 to 46 years, with a mean of 7.8 years. The data are compared with other published series of the disease in different geographical areas. Differences in the incidence of serveral complications are noted. The trend in recent years toward a lesser mortality associated with the disease is discussed.

The Influence of Emotional Factors on the Clinical Course of Ulcerative Colitis in Children

Summary From the foregoing data, certain suggestive and still tentative interrelationships seem apparent. It appears clearly established that an emotional component was operative in all of the twelve cases seen in this series. The evidence for such a component was based on the observed or historically inferred correlation between the appearance of spontaneous or experimentally induced angry or aggressive emotions and an immediate activation of a hypermotile colonic response leading to tenesmus or diarrhea. In all but one case, a precipitating event or combination of circumstances was demonstrated in relation to the onset of symptoms, occasioning simultaneously the activation of previously repressed, wholly unacceptable negative emotions and a sweeping loss of emotional support. In the group of sixteen children reported here, an apparently inverse ratio existed between personality strength or integrative capacity and the rapidity and severity of onset. In general, a more direct relationship appeared to exist between such integrative capacity and the intensity of stress required to precipitate a somatic response. Other factors, such as gastrointestinal or parenteral infection, allergy, and dietary alterations, appeared to play a predominant role in occasional exacerbations of symptomatology. During the course of psychotherapeutic play and verbal interviews, a reciprocal relationship has been suggestively demonstrated between therapeutic release of pathogenic angry or hostile emotions and the intensity of the colonic hypermotile response. The sources of the pathogenicity of such emotions for children with such dependent, rigid, immature personalities were discussed in relation to early experiences within the family constellation. A genetic component in the predisposition to disturbances of gastrointestinal function has been tentatively implicated as well, possibly involving the inheritance of specific patterns of autonomic response to emotional stress.

Observations on the Clinical Course of Non-Specific Ulcerative Colitis

The natural history and evolution of any disease process is of importance to the clinician. One of the striking features of non-specific ulcerative colitis is the periodicity of its clinical coursel-6. This important characteristic can be demonstrated only in patients with a sufficiently long history. The material for our observation consists of a group of 52 patients who were followed by one of us in Prague, and of 19 patients who were observed by the other in Chicago. This material seems to indicate that the clinical course of ulcerative colitis follows a similar pattern in both countries. The periodicity of this disease is of the relapsing type. That is, it proceeds in attacks lasting from several weeks to several months which are separated by periods of latency or remissions of varying length. During these periods when the disease process is not active the patient mayor may not be entirely asymptomatic.