Published online Sep 16, 2021. doi: 10.4253/wjge.v13.i9.407
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
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.
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.
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.
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.
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.
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.
In the future, further prospective studies to clarify the pathophysicology as well as prognosis of other various atypical patterns of UC is warranted.