RISK OF RELAPSE IN NEW CASES OF ULCERATIVE-COLITIS AND INDETERMINATE COLITIS

PURPOSE: Changes in morbidity pattern of ulcerative colitis have creat ed a need to update understanding of the course of the disease. METHOD : A follow-up study was done of relapse rates and progression of infla mmation in 571 non-selected patients with ulcerative and indeterminate colitis. RESULTS: Relapse rate ten years after diagnosis was 70 perce nt in definite ulcerative colitis, 22 percent in probable ulcerative c olitis, and 77 percent in indeterminate colitis. During the study peri od, there was no change in the relapse rate. In relapsing proctitis, 5 2 percent developed more extensive inflammation. Fifty-four percent of patients with only one attack of colitis had persistent signs of infl ammatory bowel disease. CONCLUSIONS: Shift in morbidity pat tern to a greater proportion of patients with proctitis at diagnosis and a short er time from onset of symptoms to diagnosis had no influence on the re lapse rate. Indeterminate colitis has a worse prognosis than definite ulcerative colitis. Considering the documented efficacy of sulfasalazi ne, the high relapse rate calls for studies of the effectiveness of su ch treatment in everyday practice.