The diagnostic course of ulcerative colitis in Korea / 대한내과학회지

ABSTRACT

BACKGROUND: In Korea, the incidence of ulcerative colitis has been very low, but there are few epidemiologic studies about ulcerative colitis. The aim of the present study is to obtain basic epidemiologic information about the diagnostic course of ulcerative colitis in Korea. METHODS: The diagnostic course and methods of 150 patients with ulcerative coltis were analyzed by standard questionnaire and interview. RESULTS: The median time between the onset of symptoms and diagnosis was 5 months (2 weeks-10 years). The initial diagnosis made at the institution first visited was ulcerative colitis in 31.3%, hemorrhoid in 16.7%, dysentery in 8.7%, irritable bowel syndrome in 9.3%, enteritis in 12.0%, and others in 22.0%. The diagnostic rate of ulcerative colitis among institutions was 13.0% in clinics (14/108), 28.6% in hospitals (8/28), 47.9% in general hospitals (23/48), and 83.3% in academic medical centers (105/126). Among 39 patients who have received both barium study and endoscopic evaluation at the time of diagnosis at Asan Medical Center, the overall sensitivity of barium study was 76.9% (30/39) (p=0.001). Depending on the extent of the disease, the diagnostic sensitivity of barium study was 50.0% in proctitis (5/10), 69.2% in left-sided colitis (9/13), and 100% in extensive colitis (16/16). CONCLUSION: For early detection of ulcerative colitis, it should always be considered in the differential diagnosis of rectal bleeding, and sigmoidoscopy or colonoscopy is preferred to barium study for evaluation of patients with mild symptoms. We suggest that endoscopic procedures are necessary to get more accurate epidemiologic data.