Ulcerative colitis as a progressive disease: The forgotten evidence

Authors

  • Joana Torres MD,

    1. Henry D. Janowitz Division of Gastroenterology, Mount Sinai School of Medicine, New York, New York, USA
    2. University Hospital of Lille, Department of Hepato-Gastroenterology, Lille, France
    Current affiliation:
    1. Joana Torres has received a Travel Grant from International Organization for the study of Inflammatory Bowel Disease (IOIBD) and a Grant from Burril B. Crohn Research Foundation
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  • Vincent Billioud MD,

    1. Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Université Henri Poincaré 1, Vandoeuvre-lès-Nancy, France
    2. University Hospital of Lille, Department of Hepato-Gastroenterology, Lille, France
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  • David B. Sachar MD,

    1. Henry D. Janowitz Division of Gastroenterology, Mount Sinai School of Medicine, New York, New York, USA
    2. University Hospital of Lille, Department of Hepato-Gastroenterology, Lille, France
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  • Laurent Peyrin-Biroulet MD,

    1. Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Université Henri Poincaré 1, Vandoeuvre-lès-Nancy, France
    2. University Hospital of Lille, Department of Hepato-Gastroenterology, Lille, France
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  • Jean-Frédéric Colombel MD

    Corresponding author
    1. Henry D. Janowitz Division of Gastroenterology, Mount Sinai School of Medicine, New York, New York, USA
    2. Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Université Henri Poincaré 1, Vandoeuvre-lès-Nancy, France
    3. University Hospital of Lille, Department of Hepato-Gastroenterology, Lille, France
    • Dr. Henry D. Janowitz Division of Gastroenterology, 1 Gustave Levy Place, Box 10029, New York, NY 10029-6754
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Abstract

In the management of Crohn's disease, earlier aggressive treatment is becoming accepted as a strategy to prevent or retard progression to irreversible bowel damage. It is not yet clear, however, if this same concept should be applied to ulcerative colitis. Hence, we review herein the long-term structural and functional consequences of this latter disease. Disease progression in ulcerative colitis takes six principal forms: proximal extension, stricturing, pseudopolyposis, dysmotility, anorectal dysfunction, and impaired permeability. The precise incidence of these complications and the ability of earlier, more aggressive treatment to prevent them have yet to be determined. (Inflamm Bowel Dis 2011;)

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