Abstract
Ulcerative colitis (UC) affects about 1 in 400 of the UK population, with a stable incidence in the last few decades. The peak age of onset of disease is around 30 years, but onset of disease can occur at any age, though it is rare after 70 years [1]. The strongest risk factor for developing UC is a family history of inflammatory bowel disease (IBD) (either UC or Crohn’s disease); however, the risk of monozygotic twins developing UC is lower than for Crohn’s disease (10% versus 38%) broadly suggesting that UC is less “genetic” than CD [1].
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In Memoriam: Keith Leiper 1967–2011
Dr. Keith Leiper, universally loved by his patients and by all the staff with whom he worked, all of whom he treated as his friends, died from cancer on Friday, October 21, 2011. Keith had been the Leslie Parrott Research Fellow of Crohn’s and Colitis UK and completed his M.D. on the pathogenesis and treatment of inflammatory bowel disease before going on to be a consultant with a passionate interest in clinical research. On a national level, his outstanding work as the first lead for the UK Inflammatory Bowel Disease Audit has led to a marked improvement in standards of IBD care, an achievement brought about through his close collaboration with patient organizations, particularly Crohn’s and Colitis UK for whom Keith acted as a regional medical advisor. But far more than his (formidable) list of achievements can attest, Keith was an inspiration to all who met him: exceptionally widely read, possessing a phenomenal grasp of the medical literature, an enthusiastic and much loved teacher and trainer, and immensely beneficial to the care of IBD patients locally; his personality, enormous kindness, selfless generosity, integrity, and constant good humor will be particularly remembered. He was unfailingly fun to be with, even when he became ill, and was constantly prioritizing others above himself. He is survived by his wife Libby, also a doctor, and by their children Cameron, Mirren, and Ailish to whom our thoughts go.
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References
Stange EF, Travis SPL, Vermeire S. European evidence-based consensus on the diagnosis and management of ulcerative colitis: definitions and diagnosis. J Crohns Colitis. 2008;2:1–23.
Moser G. How often do patients with IBD have symptom recurrence? Inflamm Bowel Dis. 2008;14 Suppl 2:S47. Erratum in: Inflamm Bowel Dis. 2009;15:1438–47.
Marshall JK, Irvine EJ. Rectal corticosteroids versus alternative treatments in ulcerative colitis: a meta-analysis. Gut. 1997;40:775–81.
Scott EM, Gaywood I, Scott BB. Guidelines for osteoporosis in coeliac disease and inflammatory bowel disease. British Society of Gastroenterology. Gut. 2000;46 Suppl 1:i1–8.
Papi C, Aratari A, Moretti A, Mangone M, Margagnoni G, Koch M, Capurso L. Oral beclomethasone dipropionate as an alternative to systemic steroids in mild to moderate ulcerative colitis not responding to aminosalicylates. Dig Dis Sci. 2010;55:2002–7.
Gisbert JP, Linares PM, McNicholl AG, Maté J, Gomollón F. Meta-analysis: the efficacy of azathioprine and mercaptopurine in ulcerative colitis. Aliment Pharmacol Ther. 2009;30:126–37.
Rahier JF, Yazdanpanah Y, Colombel JF, Travis S. The European (ECCO) Consensus on infection in IBD: what does it change for the clinician? Gut. 2009;58:1313–5.
Beaugerie L, Brousse N, Bouvier AM, Colombel JF, Lémann M, Cosnes J, Hébuterne X, Cortot A, Bouhnik Y, Gendre JP, Simon T, Maynadié M, Hermine O, Faivre J, Carrat F, CESAME Study Group. Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study. Lancet. 2009;374:1617–25.
Wahed M, Louis-Auguste JR, Baxter LM, Limdi JK, McCartney SA, Lindsay JO, Bloom SL. Efficacy of methotrexate in Crohn’s disease and ulcerative colitis patients unresponsive or intolerant to azathioprine/mercaptopurine. Aliment Pharmacol Ther. 2009;30:614–20.
Lawson MM, Thomas AG, Akobeng AK. Tumour necrosis factor alpha blocking agents for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2006;(3):CD005112
Rutgeerts P, Sandborn WJ, Feagan BG, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Eng J Med 2005;353:2462–76.
Ulcerative colitis (subacute manifestations)- infliximab. 2010. www.nice.org.uk/nicemedia/pdf/TA140Guidance
Farraye FA, Odze RD, Eaden J, Itzkowitz SH. AGA technical review on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology. 2010;138:746–74.
Sandborn WJ, Rutgeerts P, Feagan BG, Reinisch W, Olson A, Johanns J, Lu J, Horgan K, Rachmilewitz D, Hanauer SB, Lichtenstein GR, de Villiers WJ, Present D, Sands BE, Colombel JF. Colectomy rate comparison after treatment of ulcerative colitis with placebo or infliximab. Gastroenterology. 2009;137:1250–60.
Nguyen GC, Kaplan GG, Harris ML, Brant SR. A national survey of the prevalence and impact of Clostridium difficile infection among hospitalized inflammatory bowel disease patients. Am J Gastroenterol. 2008;103:1443–50.
Hart AL, Ng SC. Review article: the optimal medical management of acute severe ulcerative colitis. Aliment Pharmacol Ther. 2010;32:615–27.
Ohkusa T, Kato K, Terao S, Chiba T, Mabe K, Murakami K. Newly developed antibiotic combination therapy for ulcerative colitis: a double-blind placebo-controlled multicenter trial. Am J Gastroenterol. 2010;105:1820–9.
Sands BE, Sandborn WJ, Feagan B, Löfberg R, Hibi T, Wang T, Gustofson LM, Wong CJ, Vandervoort MK, Hanauer S, Adacolumn Study Group. A randomized, double-blind, sham-controlled study of granulocyte/monocyte apheresis for active ulcerative colitis. Gastroenterology. 2008;135:400–9.
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Flanagan, P., Leiper, K. (2012). Medical Management of Ulcerative Colitis. In: Brown, S., Hartley, J., Hill, J., Scott, N., Williams, J. (eds) Contemporary Coloproctology. Springer, London. https://doi.org/10.1007/978-0-85729-889-8_17
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