Correlations between defined sigmoidoscopic appearances and other measures of disease activity in ulcerative colitis
- 102 Downloads
It has been widely assumed that the activity of ulcerative colitis is related to differences in mucosal appearances seen at sigmoidoscopic examination. We have tested this assumption by making comparisons of the symptoms and clinical signs associated with three reproducible appearances of the rectal mucosa. By cross-tabulating 222 observations of each of 10 symptoms and signs with these sigmoidoscopic appearances it has been shown that the subdivision of hemorrhagic mucosae into those which bleed spontaneously and those which bleed only on light touching or scraping is meaningful clinically. Sigmoidoscopic appearances seemed to correlate better with clinical disease activity than histological assessment, even when quantitative, of mucosal biopsies. On the basis of this study, four variables have been suggested which, in addition to the sigmoidoscopic appearances, could form the basis of regular clinical assessment or scoring.
KeywordsPublic Health Clinical Sign Ulcerative Colitis Clinical Assessment Clinical Disease
Unable to display preview. Download preview PDF.
- 1.Baron JH, Connell AM, Lennard-Jones JE: Variation between observers in describing mucosal appearances in proctocolitis. Br Med J 1:89, 1964Google Scholar
- 2.Powell-Tuck J, Bown RL, Lennard-Jones JE: A comparison of oral prednisolone given as single or multiple daily doses for active proctocolitis. Scand J Gastroenterol 13:833–837, 1978Google Scholar
- 3.Buckell NA, Gould SR, Day DW, Edwards AM, Lennard-Jones, JE: A controlled trial of disodium cromoglycate in chronic persistent ulcerative colitis. Gut 19:1140–1143, 1978Google Scholar
- 4.Edwards FC, Truelove SC: The course and prognosis of ulcerative colitis. Gut 4:299, 1964Google Scholar
- 5.Truelove SC, Richards WCD: Biopsy studies in ulcerative colitis. Br Med J 1:1315–1318, 1956Google Scholar
- 6.Dick AP, Grayson JJ: Ulcerative colitis: A follow up investigation with mucosal biopsy studies. Br Med J 1:160–165, 1960Google Scholar
- 7.Matts SEF: The value of rectal biopsy in the diagnosis of ulcerative colitis. Q J Med 30:393–407, 1961Google Scholar
- 8.Wright R, Truelove SC: Serial rectal biopsy in ulcerative colitis during the course of a controlled therapeutic trial of various diets. Am J Dig Dis 11:847–857, 1966Google Scholar
- 9.Watts J McK, Thompson H, Goligher JC: Sigmoidoscopy and cytology in the detection of microscopic disease of the rectal mucosa in ulcerative colitis. Gut 7:288–294, 1966Google Scholar
- 10.Binder V: A comparison between clinical state, macroscopic and microscopic appearances of rectal mucosa and cytologic picture of mucosal exudate in ulcerative colitis. Scand J Gastroenterol 5:627–632, 1970Google Scholar