Study on Follow-Up of Ulcerative Colitis Patients on Sulfasalazine At Our Hospital – Retrospectivecohort Study.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 9
Abstract
INTRODUCTION: Ulcerative colitis is a chronic inflammatory disease of the colon of unclear etiology with an increasing incidence in India. Typical symptoms are diarrhoea, rectal bleeding, abdominal pain and fever. Sulfasalazine is effective well tolerated first line therapy for mild, moderate and severe ulcerative colitis. AIM: To Study the Clinical Remission in Ulcerative Colitis patients on Sulfasalazine at our hospital. METHODS: Retrospective data of70 Patients with Ulcerative colitis on sulfasalazine, diagnosed by Clinical, Endoscopic and Histopathologic evaluation, from year 2014-2017 at our hospital were included in the study and patients with other comorbidity, non-compliance to treatment,on azathioprine or biologicals were excluded. The primary end point was Clinical remission based on Mayo score. RESULTS: Retrospective data from 70 patients with ulcerative colitis diagnosed at our hospital from year 2014-2017 were collected. Out of 70 patients(Male=43,female=27) with age group of 24-56 years and mean age of 40 years with average symptom duration of 6 months prior to our hospital visit. All were reassessed during follow up at our hospital and classified into Mild UC group (n=23), Moderate UC group (n=31) and Severe UC group (n=16) using Truelove and Witts classification. Mild UC patients were responded in the form reduction in stool frequency from 3-4/day with blood streak to normal stool frequency with no rectal bleeding in 6 months of treatment with sulfasalazine and no exacerbations. Among Moderate UC patients 26 responded well in the form of reduction in stool frequency from 4-5/day with obvious blood to 1-2/day with no blood in stool, with 6 month of sulfasalazine and initial steroid for 10 days, 4 lost follow up, 1 was steroid dependent. Among severe UC 9 responded well from stool frequency of >6/day with frank blood to 1-2/day with occasional blood streak in stool, with 6 months of sulfasalazine and initial steroid for 10 days,03 were steroid dependent, three were refractory to conventional treatment with development of mild dysplasia on histopathology in 2 among 3 and 1 required emergency colectomy for Toxic mega colon. Meanwhile both moderate and severe UC patients developed recurrent exacerbations requiring steroid for duration of 10 days, reasons for exacerbation were Infections, change in environment (eg: Travel). CONCLUSIONS: Sulfasalazine still represents effective and well-tolerated first-line therapy for mild, moderate and severe ulcerative colitis as well as for the long-term maintenance treatment in the era of Biologicals and other Immunosuppressant.
Authors and Affiliations
Dr. S. B. Malipatil, Dr. R. Balamurali
Keywords
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- EP ID EP395473
- DOI 10.9790/0853-1709104046.
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