Natural History of Ulcerative Colitis with Coexistent Colonic Diverticulosis

Ulcerative colitis (UC) and colonic diverticulosis can co-exist in some patients. However, the natural history of UC associated with colonic diverticulosis is not well known. We here compared the disease characteristics and outcome of UC patients with and without concomitant colonic diverticulosis. Medical records of 347 UC patients were included in an observational, retrospective, nested-matched case-control study. Cases were 92 patients with UC and concomitant colonic diverticulosis, while controls were 255 UC patients without concomitant colonic diverticulosis. A propensity score matching (PSM) was used to homogenate cases (n = 92) and controls (n = 153) for age. UC patients with concomitant colonic diverticulosis were less likely to have an extensive disease (25/92, 27.1%) and to experience steroid dependence (8/92, 8.6%) compared to patients without concomitant colonic diverticulosis (70/153, 45.7% and 48/153, 31.3%, respectively; p < 0.001). The use of immunosuppressants (9/92, 9.7% vs. 37/153, 24.1%; p = 0.007) or biologics (3/92, 3.2% vs. 26/153, 16.9%, p < 0.001) was significantly lower in UC patients with concomitant diverticulosis compared to the control group. On multivariate analysis, steroid dependence and extensive colitis were significantly less frequent in UC patients with concomitant colonic diverticulosis compared to UC patients without diverticula. UC patients with coexisting colonic diverticulosis are less likely to have an extensive disease and to be steroid-dependent.

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P345 The natural history of azathioprine therapy for steroid-dependent ulcerative colitis: a Korean study

Journal of Crohn s and Colitis ◽

10.1016/s1873-9946(13)60366-9 ◽

2013 ◽

Vol 7 ◽

pp. S147-S148

Author(s):

S.K. Park ◽

S.K. Yang ◽

B.D. Ye ◽

K.J. Kim ◽

D.H. Yang ◽

...

Keyword(s):

Ulcerative Colitis ◽

Natural History ◽

Azathioprine Therapy ◽

Steroid Dependent ◽

History Of ◽

Korean Study

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Faculty Opinions recommendation of Changes in medical management and colectomy rates: a population-based cohort study on the epidemiology and natural history of ulcerative colitis in Örebro, Sweden, 1963-2010.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.729083544.793549046 ◽

2018 ◽

Author(s):

Eduard Stange ◽

Jan Wehkamp

Keyword(s):

Ulcerative Colitis ◽

Cohort Study ◽

Natural History ◽

Medical Management ◽

Population Based ◽

History Of

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The Natural History of Incidental Colonic Diverticulosis on Screening Colonoscopy

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2018/3690202 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Ala I. Sharara ◽

Nathalie Ziade ◽

Rani H. Shayto ◽

Luma Basma O. Rustom ◽

Hamed Chehab ◽

...

Keyword(s):

Natural History ◽

Acute Diverticulitis ◽

Screening Colonoscopy ◽

Colonic Diverticulosis ◽

Diverticular Bleeding ◽

Cross Sectional ◽

Acute Case ◽

Probable Case ◽

History Of ◽

Study Population

Background. The natural history of colonic diverticulosis is unclear.Methods. Patients with incidental diverticulosis identified in a previous prospective cross-sectional screening colonoscopy study were evaluated retrospectively for clinic or hospital visit(s) for diverticular disease (DD= acute diverticulitis or diverticular bleeding) using review of electronic health records and patient phone interview.Results. 826 patients were included in the screening colonoscopy study. Three were excluded for prior DD. In all, 224 patients (27.2%; mean age 62.3 ± 8.2) had incidental diverticulosis distributed in the left colon (67.4%), right colon (5.8%), or both (22.8%). Up-to-date information was available on 194 patients. Of those, 144 (74.2%) could be reached for detailed interview and constituted the study population. Over a mean follow-up of 7.0 ± 1.7 years, DD developed in 6 out of 144 patients (4.2%) (4 acute cases of diverticulitis, 1 probable case of diverticular bleeding, and 1 acute case of diverticulitis and diverticular bleeding). Two patients were hospitalized, and none required surgery. The time to event was 5.1 ± 1.6 years and the incidence rate was 5.9 per 1000 patient-years. On multivariate analysis, none of the variables collected at baseline colonoscopy including age, gender, obesity, exercise, fiber intake, alcohol use, constipation, or use of NSAIDs were associated with DD.Conclusion. The natural history of incidental diverticulosis on screening colonoscopy was highly favorable in this well-defined prospectively identified cohort. The common scenario of incidental diverticulosis at screening colonoscopy makes this information clinically relevant and valuable to physicians and patients alike.

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Clinical Features and Natural History of Patients Diagnosed With Asymptomatic Ulcerative Colitis

Inflammatory Bowel Diseases ◽

10.1097/00054725-201212001-00079 ◽

2012 ◽

Vol 18 ◽

pp. S33-S34

Author(s):

Soo-Kyung Park ◽

Byong Duk Ye ◽

Suk-Kyun Yang ◽

Jong Wook Kim ◽

Sang Hyoung Park ◽

...

Keyword(s):

Ulcerative Colitis ◽

Natural History ◽

Clinical Features ◽

History Of

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The Relationship of Drug Abuse to Unexplained Sudden Death

Archives of Pathology & Laboratory Medicine ◽

10.5858/132.12.1903 ◽

2008 ◽

Vol 132 (12) ◽

pp. 1903-1906

Author(s):

Amy C. Gruszecki ◽

Gerald McGwin, Jr ◽

C. Andrew Robinson, Jr ◽

Gregory G. Davis

Keyword(s):

Drug Abuse ◽

Cause Of Death ◽

Control Group ◽

Manner Of Death ◽

Increased Risk ◽

History Of ◽

Matched Case ◽

Relationship Of ◽

The Relationship ◽

Control Study

Abstract Context.—Forensic pathologists regularly investigate the deaths of individuals with a history of drug abuse. Autopsy, including toxicology testing, reveals no cause for death in a subset of this cohort. Objective.—To determine whether deaths with an undetermined cause and manner of death are associated with a history of drug abuse. Design.—Retrospective matched case-control study of 52 decedents whose cause of death remained undetermined following autopsy, matched 1:2 to a control group of living patients admitted for cholecystectomy according to age and date of death or procedure. Results.—Individuals whose cause of death was undetermined were 5.3 times (95% confidence interval, 1.9– 14.5) more likely to have a history of drug abuse than were patients with cholecystitis. Conclusions.—Decedents with a history of chronic drug abuse appear to be at an increased risk of dying by their chronic drug abuse, even in the absence of any anatomical or toxicologic finding at autopsy to account for death.

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Mo1339 Prevalence, Clinical Features, and Natural History of Asymptomatic Ulcerative Colitis

Gastroenterology ◽

10.1016/s0016-5085(13)62372-0 ◽

2013 ◽

Vol 144 (5) ◽

pp. S-640-S-641

Author(s):

Soo-kyung Park ◽

Byong Duk Ye ◽

Suk-Kyun Yang ◽

Jong Wook Kim ◽

Sang Hyoung Park ◽

...

Keyword(s):

Ulcerative Colitis ◽

Natural History ◽

Clinical Features ◽

History Of

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Sa1272 Natural History of Pediatric Ulcerative Colitis: an Italian Population-Based Cohort Study

Gastroenterology ◽

10.1016/s0016-5085(12)60979-2 ◽

2012 ◽

Vol 142 (5) ◽

pp. S-260

Author(s):

Caterina Strisciuglio ◽

Eleonora Giannetti ◽

Massimo Martinelli ◽

Elisa Sciorio ◽

Annamaria Staiano ◽

...

Keyword(s):

Ulcerative Colitis ◽

Cohort Study ◽

Natural History ◽

Population Based ◽

Italian Population ◽

History Of

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Natural history of pediatric ulcerative colitis: An Italian population-based cohort study

Digestive and Liver Disease ◽

10.1016/j.dld.2013.08.212 ◽

2013 ◽

Vol 45 ◽

pp. e297

Author(s):

E. Giannetti ◽

C. Strisciuglio ◽

M. Martinelli ◽

A. Alessandrella ◽

M.L. Andreozzi ◽

...

Keyword(s):

Ulcerative Colitis ◽

Cohort Study ◽

Natural History ◽

Population Based ◽

Italian Population ◽

History Of

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P286 Rate of colectomy in ulcerative colitis: Results from a Spanish cohort with 15 years of follow-up

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.415 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S295-S296

Author(s):

C Rodriguez Gutiérrez ◽

A Elosua Gonzalez ◽

C Prieto Martínez ◽

S Rubio Iturria ◽

M A Vicuña ◽

...

Keyword(s):

Ulcerative Colitis ◽

Natural History ◽

Therapeutic Strategies ◽

Definitive Diagnosis ◽

Biological Drugs ◽

History Of ◽

Incident Cohort ◽

The Impact ◽

Spanish Cohort

Abstract Background Knowing the natural history of ulcerative colitis (UC) is essential to understand the evolution of the disease, assess the impact of different therapeutic strategies, identify poor prognostic factors and provide patients with understandable information who help them in decision making. It has been suggested that biological drugs could modify natural history of UC and therefore decrease the rates of colectomy. In Spain, infliximab is approved for CU since 2005. Methods We performed a retrospective study that includes all patients with a definitive diagnosis (DD) of UC or Unclassifiable Colitis (UC) in the Navarra Incident Cohort (which includes all patients diagnosed between 2001 and 2003 in Navarra, Spain). Our objectives were to analyse the Colectomy Incidence Rate (CIR) from diagnosis to the end of follow-up (12-31-2017) and identify predictive factors of colectomy. Results We included 174 patients with DD of UC (42.5% E2 - 26.8% E3) and 5 of IC: 44.1 women, median age 39.2 years (7–88), median follow-up of 15.7 years. At the end of the follow-up, 8 patients underwent colectomy (CIR 3 surgeries per 100000patients-year). Timing of colectomy was: 3 at the initial diagnosis (<1 month), 2 in the first 2 years, 2 at 5 years and 1 at 12 years from diagnosis. All had previously received steroids, 5 immunomodulators and 2 biological agents. In 7 (87%) the surgery was urgent and the indication, megacolon in 3 (37.5%), severe outbreak in 3 (37.5%) and failure to medical treatment in 2 (25%). In 5 cases (62.5%), an ileoanal reservoir was made and in 3 definitive ileostomy. Conclusion In our cohort, global colectomy rates are lower than those reported in other series and occur mostly in the first 5 years of evolution.

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