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P255 Proximal extension rate of distal disease in Ulcerative Colitis

A. Bousseloub*1, A. Balamane2, N. Bounab2, L. Kecili2, K. Belhocine2, N. Kaddache2, K. Layaida2, L. Gamar2, T. Boucekkine2, S. Berkane2

1Hôpital Central de l'armée , Faculty of Medicine, Algiers, Algeria, 2CHU Mustapha, Faculty of Medicine, Algiers, Algeria

Background

Long term proximal extension (PE) of distal disease in Ulcerative Colitis (UC) has been variously assessed

Methods

To determine the incidence, characteristics and predictive factors of PE of distal lesions of UC, we have reviewed the outcome of 324 UC patients hospitalized from 1/1/1989 to 31/12/1998 and followed-up at least during 10 years after diagnosis or until colectomy. All patients underwent complete investigation at diagnosis and clinical controls every 6 or 12 months and on demand. The cohort included 168 females (51,8%) and 156 males (48,2%); mean age at diagnosis : 32,6 years; 22,4% were active smokers and 8,6% previous smokers. At diagnosis 54 patients (16,6%) had Proctitis (PR), 207 (63,8%). Left Sided Colitis (LSC) and 63 (19,6%) Extensive Colitis (EC). 192 patients (59,3%) received only Aminosalicylates, 132 (40,7%) Corticosteroids and 46 (14,1%) Immunosupresive drugs (ISD). Statistical Analysis X2 and Fisher's exact tests.

Results

- PE was evaluated from 0 to 1, 1 to 5, 5 to 10 years (y)

- PR remained stable from 0 to 1 y; extension of disease to LSC was

noted in 7 cases (13%) at 5 y and in 5 patients (9,2%) at 10 y; extension

to EC was observed in 5 cases (9,2%) at 10 y. Total PE of PR : 31,5% at

10y

- Progression of LSC to EC was noted in 13 patients (6,3%) from 0 to 1 y,

in 27 cases (13%) from 1 to 5 y and 23 cases (11,1%) at 10y. Total PE of

LSC: 30,4% at 10y

Regarding to predictive factors of PE : 1/there was no influence of age

(p=0,9994), gender (p=0,9208) smoking habits (p=0,7609), need for

corticosteroids (p=0,6088) or severity of the initial flare (p=0,3755).

2/on the contrary severity the disease on the long term (p<0,0001) and

need for ISD (p<0,0001) were predictive factors for PE.

Conclusion

In that 10 year follow up study PE of PR and LSC in UC has been noted in 24,7% of cases and was strongly associated to severity of disease and need for IS drugs.