PMID- 29662931
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220317
IS  - 2341-4545 (Print)
IS  - 2387-1954 (Electronic)
IS  - 2387-1954 (Linking)
VI  - 25
IP  - 2
DP  - 2018 Mar
TI  - Ulcerative Colitis: Are We Neglecting Its Progressive Character.
PG  - 74-79
LID - 10.1159/000481263 [doi]
AB  - INTRODUCTION: Ulcerative colitis (UC) is a chronic disease but its progressive 
      character, with structural damage, is insufficiently studied. OBJECTIVES: To 
      analyze a group of patients without referral bias, regarding its clinical course, 
      the morphological damage, and functional status. METHODS: We evaluated UC 
      patients diagnosed between January 1, 2000 and December 31, 2004, living in the 
      direct referral area of the hospital and determined the medication use, colectomy 
      rate, structural damage ("lead pipe," stenosis, pseudopolyps, fibrous bridges), 
      and anorectal function (prospective evaluation with the Cleveland Clinic 
      Incontinence Score [CCIS] and the Fecal Incontinence Quality of Life Scale). 
      RESULTS: We identified 104 patients, 47% female, with a mean age at diagnosis of 
      38 +/- 17 years, 24% with proctitis, 57% with left colitis, and 19% with 
      pancolitis. In 3 patients, it was not possible to obtain follow-up data. Of the 
      studied patients, 56% needed corticosteroid therapy, 38% immunosuppressants, and 
      16% anti-tumor necrosis factors (anti-TNFs). After a mean follow-up of 13 +/- 2 
      years, we found structural damage in 25 patients (24%): 5% with proctocolectomy, 
      15% with "lead pipe," 16% with pseudopolyps, and 3% with stenosis and fibrous 
      bridges. Reference to functional anorectal disorders was identified in 49%, 
      mostly previous and self-limited episodes of incontinence, but including 
      persistent incontinence in 10% (CCIS 8 +/- 4.8). There was an increased incidence 
      of structural damage and anorectal dysfunction in patients who needed 
      corticosteroid therapy (p = 0.001), immunosuppressants (p < 0.001), and anti-TNFs 
      (p = 0.002) and an association of structural damage with anorectal dysfunction (p 
      < 0.001). There was no association between age and anorectal dysfunction, 
      including incontinence episodes. CONCLUSIONS: UC is a disease with structural and 
      functional consequences in a significant subset of patients. This should be 
      incorporated when defining the therapeutic strategy.
FAU - Massinha, Paulo
AU  - Massinha P
AD  - Department of Gastroenterology, Centro Hospitalar e Universitario de Coimbra, 
      EPE, Coimbra, Portugal.
FAU - Portela, Francisco
AU  - Portela F
AD  - Department of Gastroenterology, Centro Hospitalar e Universitario de Coimbra, 
      EPE, Coimbra, Portugal.
FAU - Campos, Sara
AU  - Campos S
AD  - Department of Gastroenterology, Centro Hospitalar e Universitario de Coimbra, 
      EPE, Coimbra, Portugal.
FAU - Duque, Gabriela
AU  - Duque G
AD  - Department of Gastroenterology, Hospital Distrital da Figueira da Foz, EPE, 
      Figueira da Foz, Portugal.
FAU - Ferreira, Manuela
AU  - Ferreira M
AD  - Department of Gastroenterology, Centro Hospitalar e Universitario de Coimbra, 
      EPE, Coimbra, Portugal.
FAU - Mendes, Sofia
AU  - Mendes S
AD  - Department of Gastroenterology, Centro Hospitalar e Universitario de Coimbra, 
      EPE, Coimbra, Portugal.
FAU - Ferreira, Ana Margarida
AU  - Ferreira AM
AD  - Department of Gastroenterology, Centro Hospitalar e Universitario de Coimbra, 
      EPE, Coimbra, Portugal.
FAU - Sofia, Carlos
AU  - Sofia C
AD  - Department of Gastroenterology, Centro Hospitalar e Universitario de Coimbra, 
      EPE, Coimbra, Portugal.
FAU - Tome, Luis
AU  - Tome L
AD  - Department of Gastroenterology, Centro Hospitalar e Universitario de Coimbra, 
      EPE, Coimbra, Portugal.
LA  - eng
PT  - Journal Article
DEP - 20171020
PL  - Switzerland
TA  - GE Port J Gastroenterol
JT  - GE Portuguese journal of gastroenterology
JID - 101685861
PMC - PMC5892362
OTO - NOTNLM
OT  - Colon
OT  - Disease progression
OT  - Inflammatory bowel disease
OT  - Prognosis
OT  - Ulcerative colitis
EDAT- 2018/04/18 06:00
MHDA- 2018/04/18 06:01
PMCR- 2017/10/20
CRDT- 2018/04/18 06:00
PHST- 2017/03/14 00:00 [received]
PHST- 2017/08/19 00:00 [revised]
PHST- 2018/04/18 06:00 [entrez]
PHST- 2018/04/18 06:00 [pubmed]
PHST- 2018/04/18 06:01 [medline]
PHST- 2017/10/20 00:00 [pmc-release]
AID - pjg-0025-0074 [pii]
AID - 10.1159/000481263 [doi]
PST - ppublish
SO  - GE Port J Gastroenterol. 2018 Mar;25(2):74-79. doi: 10.1159/000481263. Epub 2017 
      Oct 20.