Clinical Features of Ulcerative Colitis in Korea

OBJECTIVES : This study was conducted to investigate the clinical features of ulcerative colitis in Korea and to evaluate the clinical course after medical therapy. METHODS : Symptoms, signs and results of the treatment were retrospectively analyzed in 66 patients (male 32, female 34) diagnosed to have ulcerative colitis at the Asan Medical Center. RESULTS : The median age of the beginning of symptoms was 36 years (range, 14–72). Diarrhea and rectal bleeding were observed in 95.1 and 91.4%, respectively, at the time of diagnosis, while extra-colonic manifestations were observed in 24.1%. In 41 patients (62.1%), colitis developed in the rectum and sigmoid colon, while left colitis and extensive colitis developed in 11 (16.7%) and 14 patients (21.2%), respectively. The severity of disease was determined according to the clinical criteria, resulting in 22 (33.3%) mild, 21 (31.8%) moderate and 23 (34.8%) severe diseases. The seventy was also classified as 1, 2 and 3 by sigmoido-colonoscopic findings: 1;17 patients(25.8%), 2;27(40.9%) and 22(33.3%). Among 23 patients with severe disease, 5 patients (7.6%) received total colectomy due to toxic megacolon, intractability to medical therapy, ileocolic fistula and intestinal stenosis. The severity determined by colonoscopic findings was well correlated with that determined clinically and was closely related to the severity of symptoms, levels of albumin, hemoglobin and the count of leukocyte. The median duration of symptoms before treatment was 4 weeks (range. 11–300). All patients were treated with sulfasalazine and prednisolone. All patients with medical therapy, except 2 patients (96. 7%), obtained clinical remission. The median days required for remission was 14 (range, 3–70). Relapse rates at 6 months, 1 year and 2 years after the initiation of treatment were 19.7, 34.1 and 49.3%, respectively. The median disease-free interval from the time of remission was 10 months (range, 2–60). After remission, the subsequent relapse rate increased in severe disease, while no difference was observed between the disease extents. CONCLUSIONS : The general characteristics of clinical manifestations and clinical course, after the medical treatment of ulcerative colitis in Korean patients, are not considerably different from those in Western countries.