title: Ulcerative colitis: analyses of 116 cases (do extraintestinal manifestations effect the time to catch remission?).
abstract: OBJECTIVE
  Evaluation of clinical, demographic and epidemiologic features of ulcerative colitis and therapy response of these patients.
  
  
  METHODS
  Retrospectively, 116 patients (64.7% female) were enrolled in this study. Mean age and mean follow-up period were 36+/-16, 5+/-2 years, respectively.
  
  
  RESULTS
  The most common anatomic involvement was pancolitis (60.3%) and the others were as follows: left side 25%, rectum 13.8% and ileum (backwash ileitis) 0.9%. Extraintestinal manifestations were observed in 42.2% of patients (sacroiliitis 12%, primary sclerosing cholangitis 7.6%, pyoderma gangrenosum 2.4%, peripheral arthropathy 1.6%, autoimmune hepatitis 1.6%, steatosis 12.9%, gallstone 0.8%, perianal fistulas 0.8%, sagittal sinus thrombosis 0.8%, psoriasis 0.8%). Multiple extraintestinal manifestations were observed (primary sclerosing cholangitis + pyoderma gangrenosum) in 2 patients. Colonic perforation due to toxic megacolon was observed in only one patient during follow-up period. The mean period for remission was 3.7 months in 72% of patients with pancolitis by the treatment of 5-aminosalicylic acid (5-ASA) (2-3 gr/day) + methylprednisolone (1 mg/kg/day) +/- (for maintenance of remission) azathioprine (AZT) (1.5-2 mg/kg/day); 3.7 months in 72% of left-sided colitis by 5-ASA +/- corticosteroid enemas +/- methylprednisolone (1 mg/kg/day) +/- (for maintenance of remission) AZT (1.5-2 mg/kg/day) and 3.7 months in 62.5% of patients with distal colitis by 5-ASA (p.o. +/- enema) +/- corticosteroid enemas. Colectomy was performed on 7 patients refractory to these treatments. Six patients (4 of them had pancolitis) were treated with cyclosporine (Cys) (4 mg/kg/day, p.o.). Only one patient, a non-responder to Cys therapy, had colectomy. The mean remission time was 4.7 months in 80.6% of patients with extraintestinal involvement and 3.2 months in 71.2% of patients without extraintestinal involvement (P=0.002).
  
  
  CONCLUSIONS
  Medical therapy was generally enough for the treatment. Cys and/or surgery can be another choice for the patients that do not respond to the medical therapy. Extraintestinal manifestations do not change the remission rate, but prolong the time to catch remission.
authors.affiliation: Istanbul University, Istanbul Medical Faculty, Department of Gastroenterohepatology, Turkey.
authors.forename: Sadakat
authors.initials: S
authors.lastname: Ozdil
authors.forename: Filiz
authors.initials: F
authors.lastname: Akyüz
authors.forename: Binnur
authors.initials: B
authors.lastname: Pinarbasi
authors.forename: Kadir
authors.initials: K
authors.lastname: Demir
authors.forename: Cetin
authors.initials: C
authors.lastname: Karaca
authors.forename: Güngör
authors.initials: G
authors.lastname: Boztas
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Kaymakoglu
authors.forename: Zeynel
authors.initials: Z
authors.lastname: Mungan
authors.forename: Fatih
authors.initials: F
authors.lastname: Besisik
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Cakaloglu
authors.forename: Atilla
authors.initials: A
authors.lastname: Okten
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D012074:Remission Induction; D012189:Retrospective Studies; D013997:Time Factors