Abstract
At the 45th Annual Congress of the Japanese Society for Abdominal Emergency Medicine held in Tokyo in 2009,I gave a lecture titled “Ulcerative Colitis” focusing on : the (1)epidemiology, (2)diverse medical treatments available, (3)progress in surgical treatment, and (4)importance of co-operation among the medical and paramedical staff in the management of ulcerative colitis. Ulcerative colitis used to be a rarely encountered condition in Japan, however, its incidence has gradually increased, and the estimated number of cases in 2007 was 90,000. Treatment with mesalazine, salazosulfapyridine, and prednisolone was common until 15 years ago, however, recent trends reveal a greater reliance on immunosuppressive agents such as azathiopurine, 6-mercaptopurine, cyclosporine A and tacrolimus, as well as leukocytapheresis. The indications for surgery are not clear, and postoperative management is difficult. While there have been no improvements in the fundamental surgical procedure, the percentage of elective operations and of one-stage restorative proctocolectomy has been increasing. Finally, I emphasized the importance of co-operation among the doctors, nurses and other paramedical staff in the management of patients with ulcerative colitis.
