Evaluation of the extent of ulcerative colitis by colonoscopy
Niv, Y.; Bat, L.; Shemesh, E.; Horowitz, A.; Ben-Ari, G.
Harefuah 101(12): 355-356
1981
ISSN/ISBN: 0017-7768 PMID: 7341375 Document Number: 176649
The observation that distal colitis has a better prognosis than total colitis is well documented. It is important to establish the proximal limit of the inflammation. Between 1978-1980, of 91 patients with inflammatory bowel disease who underwent colonoscopy, 38 fulfilled the following criteria: normal Ba enema, upper limit of inflammation not reached on rectoscopy, rectal biopsy showing typical ulcerative proctitis and unsatisfactory response to oral salazopyrine and topical steroids. The proximal limit of the disease was determined by histology. Fifteen patients had right-sided colitis and 14 pancolitis. In 32 patients, the disease extended proximal to the rectosigmoid junction. In 30 cases, the endoscopic diagnosis was in agreement with the biopsy. In 8 cases, the histology showed inflammation proximal to endoscopically normal mucosa. Colonoscopy is mandatory in patients with ulcerative colitis in whom the Ba enema is normal and the disease extends beyond rectoscopic visualization. There apparently is a considerable probability of finding pancolitis in patients who do not respond to salazopyrine or topical steroids.