title: Proximal disease extension and related predicting factors in ulcerative proctitis.
abstract: OBJECTIVE
  Ulcerative colitis usually involves the rectum, may extend in a proximal and continuous fashion to involve varying portions of the bowel. However, the risk factors predictive of proximal extension have yet to be determined. The aim of this study was to evaluate both the natural course of disease and the risk factors influencing the proximal disease extension in ulcerative proctitis.
  
  
  METHODS
  We retrospectively analyzed 98 patients with ulcerative proctitis at the time of diagnosis who were regularly followed and underwent sigmoidoscopy or colonoscopy between January 2000 and December 2007.
  
  
  RESULTS
  The mean duration of follow-up was 109.2 ± 49.5 months. A total of 27 (27.6%) patients experienced proximal disease extension. Mayo scores were significantly higher in the extension group compared with patients whose ulcerative proctitis did not extend proximally (p < 0.001). Corticosteroid use at initial diagnosis was also more frequent in the extension group (p = 0.026). In addition, chronic, continuous disease activation within 6 months of the initial diagnosis was significantly higher in the extension group (p < 0.001), as was disease relapse and the number of hospitalizations over the entire follow-up period (p < 0.001 and p = 0.002). According to multivariate analysis, disease extension after the initial diagnosis was associated with chronic disease activation, disease relapse and hospitalization (p = 0.030, p = 0.042 and p = 0.044, respectively).
  
  
  CONCLUSIONS
  Increased severity of disease upon diagnosis of ulcerative proctitis was associated with a higher probability of proximal disease extension during the follow-up period. Moreover, those with disease extension were more likely to experience relapse and to be hospitalized, indicating poor prognosis.
authors: Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine , Seoul , Korea.
authors: Bun
authors: B
authors: Kim
authors: Soo Jung
authors: SJ
authors: Park
authors: Sung Pil
authors: SP
authors: Hong
authors: Tae Il
authors: TI
authors: Kim
authors: Won Ho
authors: WH
authors: Kim
authors: Jae Hee
authors: JH
authors: Cheon
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000473:pathology*; D003106:Colon; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011350:Proctocolitis / Q000473:pathology*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012812:Sigmoidoscopy; D055815:Young Adult