Correlation of endoscopic extent and severity with the clinical presentationof ulcerative colitis

ABSTRACT

To evaluate whether the clinical presentation in patients with confirmed ulcerative colitis reflects the degree of colonoscopic activity in ulcerative colitis. Place and Duration of Study This study was conducted at the Department of Gastroenterology, PGMI, Peshawar from 1994 to 2000. Subjects and Colonoscopy was performed in 550 patients with an acute attack of severe ulcerative colitis before undergoing medical therapy. The disease was graded into mild, moderate and severe. The colonoscopic activity was assessed using a modification of Baron's criteria. Colonic involvement was divided into distal, left sided and total colitis. Major bulk of the patients were male with a mean age of 31.8 years. The disease was of mild severity in 36.3%, moderate in 47.5% and severe in 16.3%. Endoscopic extent was distal colitis in 38.1%, left sided colitis in 32.7% and total colitis in 29.1%. We found a discrepancy between clinical features and endoscopic appearances of the disease. Those presented with mild constitutional symptoms had severe disease endoscopically. Endoscopy should be performed in every patient irrespective of clinical features not only for diagnostic purpose but also for endoscopic extent and assessment of severity of disease