JOINT SYMPTOMS AFTER RESTORATIVE PROCTOCOLECTOMY IN ULCERATIVE-COLITIS AND FAMILIAL POLYPOSIS-COLI

We have determined the incidence and nature of joint symptoms in patie nts who had a restorative proctocolectomy and ileal reservoir for ulce rative colitis (UC) and familial adenomatous polyposis (FAP); we also have recorded the effect of drug treatment and surgery on these sympto ms. One hundred seventy-three patients with UC and 25 patients with FA P who had undergone a restorative proctocolectomy answered a questionn aire about joint symptoms. These were present in 96 (55%) patients wit h UC and five (20%) with FAP. In the 69 patients with UC with joint sy mptoms before proc tocolectomy, 31 (45%) reported improvement after co lectomy. However, in 27 (28%) patients with UC and joint symptoms, and four of five patients with FAP with joint symptoms, these started aft er restorative proctocolectomy, A family history of joint symptoms did not predispose to the development of arthropathy in the patients with UC but may have in patients with FAP. Before colectomy, in most patie nts with colitis, azathioprine or sulfasalazine did not improve joint symptoms, but steroids were effective in 18 of 64 patients who had rec eived them. Of 101 patients (43%) with joint symptoms in either diseas e, 43 had symptoms severe enough to interfere with daily activities. W e conclude that joint symptoms are a major cause of morbidity in patie nts with UC. After restorative proctocolectomy they may develop de nov o in patients with either UC or FAP.