Inflammatory bowel disease after 1932

The clinical diseases of ulcerative colitis (UC) and Crohn's disease (CD) w ere defined by 1932-1933. After that, the major conceptual developments wer e the recognition that regional enteritis could clearly involve the colon, and that cancer and toxic megacolon could occur in both CD and UC. In the l ast half of the 20th century the main thrust of gastroenterology at The Mou nt Sinai Hospital has been in inflammatory bowel disease (IBD), with contri butions to extra-intestinal manifestations, measurement of clinical activit y in CD, the natural history of the placebo arm of controlled trials, compl ications and therapy with corticosteroids, 5-ASA, 6-mercaptopurine, immunom odulators and cyclosporine. Actuarial life tables were introduced for posto perative recurrence and re-operation rates, as well as for quality of life analysis. Two forms of CD were defined, perforating and non-perforating, an d the role of the fecal stream was explored in light of the higher risk of recurrence after operations with anastomosis as compared with ileocolostomy .