Predictive factors for a severe clinical course in ulcerative colitis: Results from population-based studies

Abstract

Ulcerative colitis (UC) is characterized by chronic inflammation of the large bowel in genetically susceptible individuals exposed to environmental risk factors. The disease course can be difficult to predict, with symptoms ranging from mild to severe. There is no generally accepted definition of severe UC, and no single outcome is sufficient to classify a disease course as severe. There are several outcomes indicating a severe disease course, including progression of the disease’s extension, a high relapse rate, the development of acute severe colitis, colectomy, the occurrence of colorectal cancer and UC-related mortality. When evaluating a patient’s prognosis, it is helpful to do so in relation to these outcomes. Using these outcomes also makes it easier to isolate factors predictive of severe disease. The aims of this article are to evaluate different disease outcomes and to present predictive factors for these outcomes.

Keywords: Ulcerative colitis; Disease course; Prognosis; Severity; Colectomy; Relapse; Acute severe colitis; Cancer; Mortality

Core tip: The disease course of ulcerative colitis (UC) can be difficult to predict. There is no generally accepted definition of severe UC. There are several outcomes indicating a severe disease course, including progression of the disease extension, a high relapse rate, the development of acute severe colitis, colectomy, the occurrence of colorectal cancer and UC-related mortality. Using these outcomes is helpful when determining patient prognosis and also makes it easier to isolate predictive factors for severe disease. The aim of this article is to evaluate different disease outcomes and to present predictive factors for these outcomes.