Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2021; 13(9): 407-415
Published online Sep 16, 2021. doi: 10.4253/wjge.v13.i9.407
Clinical characteristics and prognosis of patients with ulcerative colitis that shows rectal sparing at initial diagnosis
Yong-Sung Choi, Jong-Kyu Kim, Wan-Jung Kim
Yong-Sung Choi, Department of Internal Medicine, Daehang Hospital, Seoul 06699, South Korea
Jong-Kyu Kim, Wan-Jung Kim, Department of Gastroenterology, Daehang Hospital, Seoul 06699, South Korea
Author contributions: Choi YS designed the research study and wrote the manuscript; Kim JK and Kim WJ analyzed the data; all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Daehang Hospital on Feb 13, 2021 (Approval No. DH21-0001).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors disclosed no conflict of interest or financial relationships relevant to this publication.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at [yschoi427@naver.com]. Participants gave informed consent for data sharing.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Sung Choi, MD, Chief Doctor, Director, Staff Physician, Department of Internal Medicine, Daehang Hospital, 2151 Nambu Beltway, Seocho-Gu, Seoul 06699, South Korea. yschoi427@naver.com
Received: April 19, 2021
Peer-review started: April 19, 2021
First decision: June 13, 2021
Revised: June 23, 2021
Accepted: August 12, 2021
Article in press: August 12, 2021
Published online: September 16, 2021
ARTICLE HIGHLIGHTS
Research background

In practice, atypical pattern of ulcerative colitis (UC) such as rectal sparing UC is a challenge to endoscopist in timely diagnosis of UC, therefore we retrospectively reviewed the data of our clinic to study the clinical feature of these atypical pattern of UC, and their prognosis as well.

Research motivation

As early diagnosis and progression of diagnostic tools such as endoscopic, imaging techniques become possible, the detection of atypical pattern of inflammatory bowel disease seems to be possible. If we clarify the clinical characteristics, it will be helpful to understand the pathophysiology of inflammatory bowel disease.

Research objectives

The main object of this study is to predict the clinical course of these atypical pattern of UC. There are very rare report concerning this subject. A few reports demonstrated the poorer prognosis, but our experiences were out of accord.

Research methods

As atypical pattern of UC is very rare and difficult to define in the early stage of UC, prospectively-designed study seems to be impossible, therefore, we (three different inflammatory bowel disease experts) inevitably analyzed the chart, pathologic report and mainly endoscopic images, and reached agreement.

Research results

Some reports suggested that the atypical pattern of UC may have a poor clinical outcome such as higher rate of colectomy, but we demonstrated the different results because the patient selection was not similar to the previous studies. Advanced treatment, hopitalization and colectomy rates did not different between rectal sparing UC and typical UC patients.

Research conclusions

According to a few previous reports, the prognosis of UC showing atypical pattern is debatable. Our data propose that various form of UC phenotype can be possible and their prognosis seems to be similar to the typical one. Further study is needed to predict the prognosis of UC.

Research perspectives

In the future, further prospective studies to clarify the pathophysicology as well as prognosis of other various atypical patterns of UC is warranted.