title: Value of colonoscopy for prediction of prognosis in patients with ulcerative colitis.
abstract: Ulcerative colitis (UC) is a chronic inflammatory bowel disorder characterized by exacerbations and remissions. Some UC patients remain refractory to conventional medical treatment while, in others, the effectiveness of drugs is limited by side-effects. Recently, cyclosporine and leukocyte removal therapy have been used for refractory UC patients. To predict the efficacy of these therapies is important for appropriate selection of treatment options and for preparation for colectomy. Endoscopy is the cornerstone for diagnosis and evaluation of UC. Endoscopic parameters in patients with severe or refractory UC may predict a clinical response to therapies, such as cyclosporine or leukocyte removal therapy. As for the patients with quiescent UC, relapse of UC is difficult to predict by routine colonoscopy. Even when routine colonoscopy suggests remission and a normal mucosal appearance, microscopic abnormalities may persist and relapse may occur later. To more accurately identify disease activity and to predict exacerbations in UC patients with clinically inactive disease is important for deciding whether medical treatment should be maintained. Magnifying colonoscopy is useful for the evaluation of disease activity and for predicting relapse in patients with UC.
authors.affiliation: Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan. takafumiando-gi@umin.ac.jp
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ando
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishio
authors.forename: Osamu
authors.initials: O
authors.lastname: Watanabe
authors.forename: Hironao
authors.initials: H
authors.lastname: Takahashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Maeda
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ishiguro
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ishikawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Ohmiya
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Niwa
authors.forename: Hidemi
authors.initials: H
authors.lastname: Goto
mesh_terms: D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000628:therapy*; D003113:Colonoscopy / Q000379:methods*; D016572:Cyclosporine / Q000494:pharmacology; D004724:Endoscopy / Q000379:methods; D005762:Gastroenterology / Q000379:methods*; D006801:Humans; D007962:Leukocytes / Q000378:metabolism; D018613:Microscopy, Confocal / Q000379:methods; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D016572:Cyclosporine