Editorial
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 14, 2008; 14(14): 2133-2138
Published online Apr 14, 2008. doi: 10.3748/wjg.14.2133
Value of colonoscopy for prediction of prognosis in patients with ulcerative colitis
Takafumi Ando, Yuji Nishio, Osamu Watanabe, Hironao Takahashi, Osamu Maeda, Kazuhiro Ishiguro, Daisuke Ishikawa, Naoki Ohmiya, Yasumasa Niwa, Hidemi Goto
Takafumi Ando, Yuji Nishio, Osamu Watanabe, Hironao Takahashi, Osamu Maeda, Kazuhiro Ishiguro, Daisuke Ishikawa, Naoki Ohmiya, Yasumasa Niwa, Hidemi Goto, Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya 4668550, Japan
Yuji Nishio, Department of Gastroenterology, Meitetsu Hospital, Nagoya 4518511, Japan
Author contributions: Ando T and Goto H contributed equally to this work; Ando T, Maeda O, Ishiguro K, Ohmiya N, and Niwa Y designed research; Ando T, Nishio Y, Watanabe O, and Takahashi H performed research; and Ando T and Nishio Y wrote the paper.
Correspondence to: Takafumi Ando, MD, Department of Gastroenterology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 4668550, Japan. takafumiando-gi@umin.ac.jp
Telephone: +81-52-7442144
Fax: +81-52-7442175
Received: January 3, 2008
Revised: January 28, 2008
Published online: April 14, 2008
Abstract

Ulcerative colitis (UC) is a chronic inflammatory bowel disorder characterized by exacerbations and remissions. Some UC patients remain refractory to conventional medical treatment while, in others, the effectiveness of drugs is limited by side-effects. Recently, cyclosporine and leukocyte removal therapy have been used for refractory UC patients. To predict the efficacy of these therapies is important for appropriate selection of treatment options and for preparation for colectomy. Endoscopy is the cornerstone for diagnosis and evaluation of UC. Endoscopic parameters in patients with severe or refractory UC may predict a clinical response to therapies, such as cyclosporine or leukocyte removal therapy. As for the patients with quiescent UC, relapse of UC is difficult to predict by routine colonoscopy. Even when routine colonoscopy suggests remission and a normal mucosal appearance, microscopic abnormalities may persist and relapse may occur later. To more accurately identify disease activity and to predict exacerbations in UC patients with clinically inactive disease is important for deciding whether medical treatment should be maintained. Magnifying colonoscopy is useful for the evaluation of disease activity and for predicting relapse in patients with UC.

Keywords: Ulcerative colitis; Colonoscopy; Prediction of outcome