Between 1970 and 1983, we studied 60 cases of ulcerative colitis by regular X-ray examination, using the double-contrast barium enema method.
Our aim was to trace the natural history of ulcerative colitis. The results were as follows :
1. Based on the size of the ulcer, its form, and whether or not it is undermined, three types may be identified : large ulceration with longitudinal extension, middle-sized ulceration and small ulceration. There were 14 cases of longitudinal extnsion with undermining, 9 of middle sized ulceration with multiple ulcerations of irregular form and size (3-4mm), and 37 of small ulceration with very small ulcers (1-3mm).
2. Some time after the fifth year, many cases of the first type were found to shift from relapsing/remitting to chronic continuous. In this first group, operation was indicated in 8 of 13 cases. In the second and third groups, the cases that shifted from relapsing/remitting to chronic continuous were relatively few. Operation was indicated in only 1 case of 8 in the second group and 2 of 33 in the third group.
Clearly, the prognosis of ulcerative colitis is closely connected with the classification by type. The prognosis of the first group was not good, whereas that for the second and third groups was.
View full abstract