The natural history of ulcerative proctitis

A multicenter, retrospective study

Gianmichele Meucci, Maurizio Vecchi, Marco Astegiano, Luigi Beretta, Pietro Cesari, Paolo Dizioli, Luca Ferraris, Maria Rita Panelli, Alberto Prada, Raffaello Sostegni, Roberto De Franchis

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

OBJECTIVE: The aim of this study was to evaluate the clinical features and the long term evolution of patients with a well defined initial diagnosis of ulcerative proctitis. METHODS: Patients with an original diagnosis of ulcerative proctitis who had been seen at any of 13 institutions from 1989 to 1994 were identified. Data on disease onset and subsequent evolution were recorded. In addition, 575 patients with more extensive disease, treated in the same centers, were used as controls. RESULTS: A total of 341 patients satisfied the inclusion criteria. The percentage of smokers in these patients was slightly lower than in controls; no differences were found in the other clinical/demographic variables evaluated. A total of 273 patients entered long term follow-up (mean, 52 months). Proximal extension of the disease occurred in 74 of them (27.1%). The cumulative rate of proximal extension and of extension beyond the splenic flexure was 20% and 4% at 5 yr and 54% and 10% at 10 yr, respectively. The risk of proximal extension was higher in nonsmokers, in patients with >3 relapses/yr, and in patients needing systemic steroid or immunosuppressive treatment. Refractory disease was confirmed as an independent prognostic factor at multivariate analysis. CONCLUSIONS: Proximal extension of ulcerative proctitis is frequent and may occur even late after the original diagnosis. However, the risk of extension beyond the splenic flexure appears to be quite low. Smoking seems to be a protective factor against proximal extension, whereas refractoriness is a risk factor for proximal extension of the disease. (C) 2000 by Am. Coll. of Gastroenterology.

Original languageEnglish
Pages (from-to)469-473
Number of pages5
JournalAmerican Journal of Gastroenterology
Volume95
Issue number2
DOIs
Publication statusPublished - Feb 2000

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Proctitis
Multicenter Studies
Retrospective Studies
Transverse Colon
Gastroenterology
Immunosuppressive Agents
Multivariate Analysis
Smoking
Steroids
Demography
Recurrence

ASJC Scopus subject areas

  • Gastroenterology

Cite this

The natural history of ulcerative proctitis : A multicenter, retrospective study. / Meucci, Gianmichele; Vecchi, Maurizio; Astegiano, Marco; Beretta, Luigi; Cesari, Pietro; Dizioli, Paolo; Ferraris, Luca; Panelli, Maria Rita; Prada, Alberto; Sostegni, Raffaello; De Franchis, Roberto.

In: American Journal of Gastroenterology, Vol. 95, No. 2, 02.2000, p. 469-473.

Research output: Contribution to journalArticle

Meucci, G, Vecchi, M, Astegiano, M, Beretta, L, Cesari, P, Dizioli, P, Ferraris, L, Panelli, MR, Prada, A, Sostegni, R & De Franchis, R 2000, 'The natural history of ulcerative proctitis: A multicenter, retrospective study', American Journal of Gastroenterology, vol. 95, no. 2, pp. 469-473. https://doi.org/10.1016/S0002-9270(99)00829-1
Meucci, Gianmichele ; Vecchi, Maurizio ; Astegiano, Marco ; Beretta, Luigi ; Cesari, Pietro ; Dizioli, Paolo ; Ferraris, Luca ; Panelli, Maria Rita ; Prada, Alberto ; Sostegni, Raffaello ; De Franchis, Roberto. / The natural history of ulcerative proctitis : A multicenter, retrospective study. In: American Journal of Gastroenterology. 2000 ; Vol. 95, No. 2. pp. 469-473.
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AU - Dizioli, Paolo

AU - Ferraris, Luca

AU - Panelli, Maria Rita

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N2 - OBJECTIVE: The aim of this study was to evaluate the clinical features and the long term evolution of patients with a well defined initial diagnosis of ulcerative proctitis. METHODS: Patients with an original diagnosis of ulcerative proctitis who had been seen at any of 13 institutions from 1989 to 1994 were identified. Data on disease onset and subsequent evolution were recorded. In addition, 575 patients with more extensive disease, treated in the same centers, were used as controls. RESULTS: A total of 341 patients satisfied the inclusion criteria. The percentage of smokers in these patients was slightly lower than in controls; no differences were found in the other clinical/demographic variables evaluated. A total of 273 patients entered long term follow-up (mean, 52 months). Proximal extension of the disease occurred in 74 of them (27.1%). The cumulative rate of proximal extension and of extension beyond the splenic flexure was 20% and 4% at 5 yr and 54% and 10% at 10 yr, respectively. The risk of proximal extension was higher in nonsmokers, in patients with >3 relapses/yr, and in patients needing systemic steroid or immunosuppressive treatment. Refractory disease was confirmed as an independent prognostic factor at multivariate analysis. CONCLUSIONS: Proximal extension of ulcerative proctitis is frequent and may occur even late after the original diagnosis. However, the risk of extension beyond the splenic flexure appears to be quite low. Smoking seems to be a protective factor against proximal extension, whereas refractoriness is a risk factor for proximal extension of the disease. (C) 2000 by Am. Coll. of Gastroenterology.

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