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[Clinical observations of ulcerative colitis].

WATANABE, H., HIWATASHI, N. and YAMAGATA, S. Clinical Observations on Ulcerative Colitis. Tohoku J. exp. Med., 1977, 123 (3), 197-213 Based on the clinical results in 159 cases of ulcerative colitis experienced in our Department during the years 1954-1975, various clinical aspects such as incidence, symptoms, clinical findings, complications, treatment and prognosis were in vestigated. Fromthese observations, the following results were obtained: 1) Ulcerative colitis is not as rare as previously considered. It is slightly female predominant and seen most often in adolescents and adults. However, one of the most interesting findings is the secondary increase in incidence in older people, producing a bimodal curve. 2) One third of the total cases of ulcerative colitis belongs to the category of proctitis at the time of diagnosis. 3) Classical ulcerative colitis such as total colitis and left-sided colitis is characterized by mucous bloody stools as its chief symptom and often accompanied by fever, loss of weight, a rise in blood sedimentation rate, anemia, leucocytosis, hypoproteinemia, lowering of A/G ratio and hypopotassemia. These fingings, except for bloody stool, were not commonly found in proctitis. However, findings of procto sigmoidoscopy, cytologic examination, biopsy and radiological examination between classical ulcerative colitis and proctitis were similar. On the other hand, the lesion progressed to a part or all of the colon in 7 of 38 cases (18%) of proctitis during the observation period. Proctitis is, therefore, thought to be a part of ulcerative colitis. 4) The evaluation of medical treatment discloses that remission was obtained in 21 of 46 cases (46%) of total colitis, in 24 of 35 cases (69%) of left-sided colitis and in 31 of 38 cases (82%) of proctitis. Surgical intervention became necessary in 24 of 46 cases (52%) of total colitis, in 5 of 29 cases (17%) of left-sided colitis and in only one of 31 cases (3%) of proctitis. 5) Follow up studies revealed the recurrence of symptoms in many cases, although most patients were capable of maintaining normal lives. ulcerative colitis; proctitis