Choi YS, Kim JK, Kim WJ. Clinical characteristics and prognosis of patients with ulcerative colitis that shows rectal sparing at initial diagnosis. World J Gastrointest Endosc 2021; 13(9): 407-415 [PMID: 34630890 DOI: 10.4253/wjge.v13.i9.407]
Corresponding Author of This Article
Yong-Sung Choi, MD, Chief Doctor, Director, Staff Physician, Department of Internal Medicine, Daehang Hospital, 2151 Nambu Beltway, Seocho-Gu, Seoul 06699, South Korea. yschoi427@naver.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Sep 16, 2021; 13(9): 407-415 Published online Sep 16, 2021. doi: 10.4253/wjge.v13.i9.407
Clinical characteristics and prognosis of patients with ulcerative colitis that shows rectal sparing at initial diagnosis
Yong-Sung Choi, Jong-Kyu Kim, Wan-Jung Kim
Yong-Sung Choi, Department of Internal Medicine, Daehang Hospital, Seoul 06699, South Korea
Jong-Kyu Kim, Wan-Jung Kim, Department of Gastroenterology, Daehang Hospital, Seoul 06699, South Korea
Author contributions: Choi YS designed the research study and wrote the manuscript; Kim JK and Kim WJ analyzed the data; all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Daehang Hospital on Feb 13, 2021 (Approval No. DH21-0001).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors disclosed no conflict of interest or financial relationships relevant to this publication.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at [yschoi427@naver.com]. Participants gave informed consent for data sharing.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Sung Choi, MD, Chief Doctor, Director, Staff Physician, Department of Internal Medicine, Daehang Hospital, 2151 Nambu Beltway, Seocho-Gu, Seoul 06699, South Korea. yschoi427@naver.com
Received: April 19, 2021 Peer-review started: April 19, 2021 First decision: June 13, 2021 Revised: June 23, 2021 Accepted: August 12, 2021 Article in press: August 12, 2021 Published online: September 16, 2021 Processing time: 143 Days and 22.3 Hours
ARTICLE HIGHLIGHTS
Research background
In practice, atypical pattern of ulcerative colitis (UC) such as rectal sparing UC is a challenge to endoscopist in timely diagnosis of UC, therefore we retrospectively reviewed the data of our clinic to study the clinical feature of these atypical pattern of UC, and their prognosis as well.
Research motivation
As early diagnosis and progression of diagnostic tools such as endoscopic, imaging techniques become possible, the detection of atypical pattern of inflammatory bowel disease seems to be possible. If we clarify the clinical characteristics, it will be helpful to understand the pathophysiology of inflammatory bowel disease.
Research objectives
The main object of this study is to predict the clinical course of these atypical pattern of UC. There are very rare report concerning this subject. A few reports demonstrated the poorer prognosis, but our experiences were out of accord.
Research methods
As atypical pattern of UC is very rare and difficult to define in the early stage of UC, prospectively-designed study seems to be impossible, therefore, we (three different inflammatory bowel disease experts) inevitably analyzed the chart, pathologic report and mainly endoscopic images, and reached agreement.
Research results
Some reports suggested that the atypical pattern of UC may have a poor clinical outcome such as higher rate of colectomy, but we demonstrated the different results because the patient selection was not similar to the previous studies. Advanced treatment, hopitalization and colectomy rates did not different between rectal sparing UC and typical UC patients.
Research conclusions
According to a few previous reports, the prognosis of UC showing atypical pattern is debatable. Our data propose that various form of UC phenotype can be possible and their prognosis seems to be similar to the typical one. Further study is needed to predict the prognosis of UC.
Research perspectives
In the future, further prospective studies to clarify the pathophysicology as well as prognosis of other various atypical patterns of UC is warranted.
