Ulcerative Colitis

  • H. Wehrli
  • A. Akovbiantz
Conference paper


Ulcerative colitis is a usually chronic inflammatory disease of the colon of largely unknown etiology [48, 60]. It was first described by Samual Wilkes of London in 1859 [19]. Ulcerative colitis, unlike Crohn’s disease, is generally limited to the mucosa and submucosa of the colon [96] except in cases where the disease takes an acute, fulminating, toxic course. Inflammation of the terminal ileum (“backwash ileitis”) is seen only when the disease process involves the entire colon. Ulcerative colitis begins distally and may spread proximally and continuously throughout the large bowel. The rectum is involved in 98% of cases [88]. The disease may have its onset at any age but most commonly appears in the 2nd–4th decades [21]. Childhood onset of ulcerative colitis, seen in 25% of cases [20], implies a very poor prognosis [96].


Ulcerative Colitis Restorative Proctocolectomy Toxic Megacolon Ileoanal Anastomosis Ileal Reservoir 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Akovbiantz A (1981) Kontinenzerhaltende Operationen bei der Colitis ulcerosa. Helv Chir Acta 48: 789–796Google Scholar
  2. 2.
    Albrechtsen D, Bergau A, Nygaard K, Gjone E, Flat-mack A (1981) Urgent surgery for ulcerative colitis: early colectomy in 132 patients. World J Surg 5: 607–615PubMedCrossRefGoogle Scholar
  3. 3.
    Allsop JR, Lee E (1978) Factors which influenced postoperative complications in patients with ulcerative colitis or Crohn’s disease of the colon on corticosteroids. Gut 19: 729–734PubMedCrossRefGoogle Scholar
  4. 4.
    Athanasiadis S, Kuhlgatz CH, Girona J (1984) Zur Wertigkeit der ileorektalen Anastomose bei der Behandlung der Colitis ulcerosa. Zbl Chirurgie 109: 1179–1206Google Scholar
  5. 5.
    Baker W, Aylett SO, Glass RE, Ritchie JK (1978) Cancer of the rectum following colectomy and ileo-rectal anastomosis for ulcerative colitis. Br J Surg 65: 862–868PubMedCrossRefGoogle Scholar
  6. 6.
    Bansky G, Bühler H, Stamm B, Häcki WH, Buchmann P, Müller J (1987) Treatment of distal ulcerative colitis with betamethasone enemas: high therapeutic efficacy without endocrine side effects. Dis Colon Rectum 30: 288–292PubMedCrossRefGoogle Scholar
  7. 7.
    Bauer J, Gelernt IM, Salky B, Kreel I (1983) Sexual dysfunction following proctocolectomy for benign disease of the colon and rectum. Ann Surg 197: 363–367PubMedCrossRefGoogle Scholar
  8. 8.
    Becker JM, Hillard HE, Mann FA, Kestenberg A, Nelson JA (1985) Functional assessment after colectomy, mucosal proctectomy and endorectal ileoanal pull-through. World J Surg 9: 598–605PubMedCrossRefGoogle Scholar
  9. 9.
    Becker V (1982) Pathologische Anatomie entzündlicher Darmerkrankungen. Colo-proctology 4: 347–350Google Scholar
  10. 10.
    Berry AR, de Campos R, Lee ECG (1986) Perineal and pelvic morbidity following perimuscular excision of the rectum for inflammatory bowel disease. Br J Surg 73: 675–677PubMedCrossRefGoogle Scholar
  11. 11.
    Buchmann P (1983) Colitis ulcerosa und Colonpolypose: Die Erhaltung des Rectums. Helv Chir Acta 509: 587–591Google Scholar
  12. 12.
    Burnham W, Lennard-Jones J, Stanford JL, Bird RG (1978) Mycobacteria as a possible cause of inflammatory bowel disease. Lancet 2: 693–696PubMedCrossRefGoogle Scholar
  13. 13.
    Campbell DES (1986) Therapie der Colitis ulcerosa auf der Basis von 5-Amino-Salicylsäure. Schwerpunkt Med 9: 12–20Google Scholar
  14. 14.
    Carlstedt A, Fasth S, Hultén L, Nordgreen S, Palsel-ius I (1987) Long-term ileostomy complications in patients with ulcerative colitis and Crohn’s disease. Int J Colorect Dis: 22–25Google Scholar
  15. 15.
    Caprilli R, Vernia P, Colaneri O, Frieri G (1980) Risk factors in toxic megacolon. Dig Dis Sci 25: 817–822PubMedCrossRefGoogle Scholar
  16. 16.
    Cello JP (1983) Ulcerative colitis. In: Sleisenger M, Fordtran J (eds) Gastrointestinal disease, 3rd edn. Saunders, PhiladelphiaGoogle Scholar
  17. 17.
    Chapman RW, Selby WS, Jewell DP (1986) Controlled trial of intravenous metronidazole as an adjunct to corticosteroids in severe ulcerative colitis. Gut 27: 1210–1212PubMedCrossRefGoogle Scholar
  18. 18.
    Clark M (1986) Role of nitrition in inflammatory bowel disease: an overview. Gut 27: 72–75PubMedCrossRefGoogle Scholar
  19. 19.
    Coran AG (1985) New surgical approaches to ulcerative colitis in children and adults. World J Surg 9: 203–213PubMedCrossRefGoogle Scholar
  20. 20.
    Dick W (1986) Chronisch-entzündliche Darmerkrankungen. Der informierte Arzt 20: 8–12Google Scholar
  21. 21.
    Dölle W, Herfarth C (1979) Diagnose und Therapie chronisch-entzündlicher Darmerkrankungen. Med Welt 30/29: 1120–1124PubMedGoogle Scholar
  22. 22.
    Dozois RR, de Calan L (1985) Rectocolite ulcéro-hémorragique: alternatives chirurgicales à l’iléosto-mie conventionnelle de Brooke. Gastroenterol Clin Biol 9: 687–689PubMedGoogle Scholar
  23. 23.
    Feinberg S, McLeod RS, Cohen Z (1987) Complications of loop ileostomy. Am J Surg 153: 102–107PubMedCrossRefGoogle Scholar
  24. 24.
    Fonkalsrud EW (1981) Endorectal ileal pullthrough with lateral ileal reservoir for benign colorectal disease. Ann Surg 194: 761–766PubMedCrossRefGoogle Scholar
  25. 25.
    Friedmann LS, Richter JM, Kirkham SE, DeMonaco HJ, May RJ (1986) 5-Aminosalicylic acid enemas in refractory distal ulcerative colitis: a randomized con-trolled trial. Am J Gastroenterol 81: 412–418Google Scholar
  26. 26.
    Gaisberg U, Töpfer HU (1984) Medikamentöse Therapie der Colitis ulcerosa und des M. Crohn. In: Gaisberger U (ed) Colitis ulcerosa — M. Crohn: II. Fortbildungsveranstaltung, Bad Cannstatt 1984. Fak Foundation eV, Habsburgerstr. 81, D-7800 Freiburg i. Br.Google Scholar
  27. 27.
    Gilat T (1983) Incidence of inflammatory bowel disease: going up or down? Gastroenterology 85: 194–203Google Scholar
  28. 28.
    Gloor F (1981) Die nicht klassifizierbaren ulzerösen Kolitiden. Schweiz Med Wochenschr 111: 779–783PubMedGoogle Scholar
  29. 29.
    Goligher JC (1981) Current efforts to retain continence in the surgery of ulcerative colitis. Schweiz Med Wochenschr 111: 784–789PubMedGoogle Scholar
  30. 30.
    Goligher JC (1981) Eversion technique for distal mucosal proctectomy in ulcerative colitis: a preliminary report. Br J Surg 71: 26–28CrossRefGoogle Scholar
  31. 31.
    Greenstein AJ, Barth JA, Sachar DB, Aufses AH (1986) Free colonic perforation without dilatation in ulcerative colitis. Am J Surg 152: 272–275PubMedCrossRefGoogle Scholar
  32. 32.
    Grundfest SF, Fazio V, Weiss RA, Jagelmann D, Lavery I, Weakley FL, Turnbull RB (1981) The risk of cancer following colectomy and ileorectal anasto-mosis for extensive mucosal ulcerative colitis. Ann Surg 193: 9–14PubMedCrossRefGoogle Scholar
  33. 33.
    Gyde SN, Prior P, Thompson H, Waterhouse JAH, Allan RN (1984) Survival of patients with colorectal cancer complicating ulcerative colitis. Gut 25: 228–231PubMedCrossRefGoogle Scholar
  34. 34.
    Haferkamp O (1981) M. Crohn und Colitis ulcerosa — Standortbestimmung: pathologisch-anatomische Aspekte. Chirurg 52: 737–743PubMedGoogle Scholar
  35. 35.
    Halter F (1981) Differentialdiagnose der Colitis ulcerosa. Schweiz Med Wochenschr 111: 773–778PubMedGoogle Scholar
  36. 36.
    Hartmann F (1986) 5-Aminosalicylsäure: Neue The-rapiemöglichkeit bei chronisch entzündlicher Darmerkrankung? Leber Magen Darm 16: 20–27PubMedGoogle Scholar
  37. 37.
    Hassler H, Grossmann S, Fischer L, Oesch A (1984) Colitis ulcerosa: Die notfallmäßige Operation beim toxischen Megacolon mit Perforation. Helv Chir Acta 51: 47–50PubMedGoogle Scholar
  38. 38.
    Hawley PR (1985) Ileorectal anastomosis. Br J Surg 72 [Suppl]: 75–82CrossRefGoogle Scholar
  39. 39.
    Herfarth C (1983) Chronisch-entzündliche Darmerkrankungen — Indikation zur Operation. Z Gastroenterol 21: 27–34Google Scholar
  40. 40.
    Herfarth C, Otto HF (1987) Carcinom-praeventive Operationsindikationen bei entzündlichen Darmerkrankungen. Chirurg 58: 221–227PubMedGoogle Scholar
  41. 41.
    Herfarth C, Stern J (1986) Die kontinenzerhaltende Proktocolectomie. Chirurg 57: 263–270PubMedGoogle Scholar
  42. 42.
    Jalan K (1970) An experience of ulcerative colitis. II. Short term outcome, III. Long term outcome. Gastroenterology 59: 589–609PubMedGoogle Scholar
  43. 43.
    Kewenter J, Hultén L, Ahlman H (1978) Cancer risk in extensive colitis. Ann Surg 188: 824–828PubMedCrossRefGoogle Scholar
  44. 44.
    Kim YS, Byrd JC (1984) Ulcerative colitis: a specific mucin defect? Gastroenterology 87: 1193–1195PubMedGoogle Scholar
  45. 45.
    Kock N (1977) Ileostomy. Curr Probl Surg 14:18–47CrossRefGoogle Scholar
  46. 46.
    Kock N, Myrvold HE, Nilsson LO, Philipson BM (1985) Achtzehn Jahre Erfahrung mit der kontinenten Ileostomie. Chirurg 56: 299–304PubMedGoogle Scholar
  47. 47.
    Kommerell B (1981) Colitis ulcerosa und M. Crohn. Der informierte Arzt 15: 34–40Google Scholar
  48. 48.
    Kremer K, Rumpf P, Ehms H, Strohmeyer G (1981) Colitis ulcerosa. In: Allgöwer M, Siewert JR, Blum AL (eds) Chirurgische Gastroenterologie. Springer, Berlin Heidelberg New YorkGoogle Scholar
  49. 49.
    Lennard-Jones JE (1986) Compliance, cost and common sense limit cancer control in colitis. Gut 27: 1403–1407PubMedCrossRefGoogle Scholar
  50. 50.
    Lennard-Jones JE (1985) Cancer risk in ulcerative colitis: surveillance or surgery. Br J Surg 72: 84–86CrossRefGoogle Scholar
  51. 51.
    Lennard-Jones JE (1983) Toward optimal use of corticosteroids in ulcerative colitis and Crohn’s disease. Gut 24: 177–181PubMedCrossRefGoogle Scholar
  52. 52.
    Lockart-Mummery HE (1968) Diffuse conditions of the large bowel which are premalignant. Br J Surg 55:737Google Scholar
  53. 53.
    Lupinetti M, Mehigan D, Cameron JL (1980) Hepatobiliary complications of ulcerative colitis. Ann J Surg 139:113–118CrossRefGoogle Scholar
  54. 54.
    Maier K, Gaisberg U (1986) Klinische Erfahrungen mit der rectalen und oralen Applikation mit 5-Ami-nosalicylsäure. In: Ewe K (ed) Therapie chronischentzündlicher Darmerkrankungen. Schattauer, StuttgartGoogle Scholar
  55. 55.
    Matuchansky C (1986) Parenteral nutrition in inflammatory bowel disease. Gut 27: 81–84PubMedCrossRefGoogle Scholar
  56. 56.
    Mayberry JF (1985) Some aspects of the epidemiology of ulcerative colitis. Gut 26: 968–974PubMedCrossRefGoogle Scholar
  57. 57.
    McCafferty MH, Fazio V (1985) Ileoanale Anastomose bei Colitis ulcerosa. Chirurg 56: 293–298PubMedGoogle Scholar
  58. 58.
    Mclntyre PB, Lennard-Jones JE, Powell-Tuck J, Wood SR, Zerebours E, Hecketsweiler P, Colin R, Galmiche J-P (1986) Controlled trial of bowel rest in the treatment of severe acute colitis. Gut 27: 481–485CrossRefGoogle Scholar
  59. 59.
    Mee AS, Shield AS, Burke M (1985) Campylobacter colitis: differentiation from acute inflammatory bowel disease. J R Soc Med 78: 217–223PubMedGoogle Scholar
  60. 60.
    Meister R, Schmidt R (1986) Chirurgische Therapie der Colitis ulcerosa. Colo-proctology 1: 15–23Google Scholar
  61. 61.
    Merkle P (1983) Colitis ulcerosa. Münch Med Wochenschr 125: 255–258Google Scholar
  62. 62.
    Meyer J (1973) Ulcerative colitis. In: Sleisenger M, Fordtran J (eds) Gastrointestinal disease. Saunders, Philadelphia, pp 1296–1349Google Scholar
  63. 63.
    Miller B (1978) Chronisch-entzündliche Darmerkrankungen: Colitis ulcerosa und M. Crohn. In: Bock E et al. (eds) Klinik der Gegenwart, vol 10. Urban and Schwarzenberger, München, pp 442 a-E 460Google Scholar
  64. 64.
    Miller JP (1986) Inflammatory bowel disease in pregnancy: a review. J R Soc Med 79: 221–225PubMedGoogle Scholar
  65. 65.
    Mir-Nadjlessi SH, Farmer RG, Easley KA, Beck GJ (1986) Colorectal and extracolonic malignancy in ulcerative colitis. Cancer 58: 1569CrossRefGoogle Scholar
  66. 66.
    Mock DM (1986) Growth retardation in chronic inflammatory bowel disease. Gastroenterology 91: 1019–1023PubMedGoogle Scholar
  67. 67.
    Morel P, Alexander-Williams J, Hawker PC, Allan RN, Dykes PW (1986) Management of acute colitis in inflammatory bowel disease. World J Surg 10: 814–819PubMedCrossRefGoogle Scholar
  68. 68.
    Morowitz D, Kirsner JB (1981) Ileostomy in ulcerative colitis. Ann J Surg 141: 370–375CrossRefGoogle Scholar
  69. 69.
    Morson BC (1968) Pathology of ulcerative colitis. Baillière Tindall and Cassell, LondonGoogle Scholar
  70. 70.
    Morson BC (1983) Kolorektale Biopsie bei entzündlichen Darmerkrankungen. Leber Magen Darm 13:261–269PubMedGoogle Scholar
  71. 71.
    Mottet NK (1971) Histopathologic spectrum of regional enteritis and ulcerative colitis. Saunders, Philadelphia, Major problems in pathology, vol 2Google Scholar
  72. 72.
    Muto T, Kamiya J, Sawada T, Kubota Y, Morioka Y, Chida T, Okamura N, Nakaya R (1985) Die Beziehung zwischen Bacteroides und Colitis ulcerosa. Colonproctology 2: 73–74Google Scholar
  73. 73.
    Nasmyth DG, Johnston D, Godwin PGR, Dixon MF, Williams NS, Smith A (1986) Factors influencing bowel function after ileal pouch-anal anastomosis. Br J Surg 73: 469–473PubMedCrossRefGoogle Scholar
  74. 74.
    Neal DE, Johnston D, Williams NS (1982) Rectal, bladder and sexual function after mucosal proctectomy with and without a pelvic reservoir for colitis and polyposis. Br J Surg 69: 599–604PubMedCrossRefGoogle Scholar
  75. 75.
    Nicholls RJ, Pezim ME (1985) Restorative proctocolectomy with ileal reservoir for ulcerative colitis and familial adenomatous polyposis: a comparison of three reservoir designs. Br J Surg 72: 470–474PubMedCrossRefGoogle Scholar
  76. 76.
    Nicholls JR, Moskowitz RL, Shepherd NA (1985) Restorative proctocolectomy with ileal reservoir. Br J Surg 72: 76–79CrossRefGoogle Scholar
  77. 77.
    Nicholls J, Pescatori M, Motson RW, Pezim ME (1984) Restorative proctocolectomy with a three-loop ileal reservoir for ulcerative colitis and familial adenomatous polyposis. Ann Surg 199: 383–388PubMedCrossRefGoogle Scholar
  78. 78.
    Nostrant TT (1987) Histopathology differentiates acute self-limited colitis from ulcerative colitis. Gastroenterology 92: 318–328PubMedGoogle Scholar
  79. 79.
    Nugent FW, Haggitt RC, Colcher H, Kutteruf GC (1979) Malignant potential of chronic ulcerative colitis. Gastroenterology 76: 1PubMedGoogle Scholar
  80. 80.
    Otto HF (1981) Immunpathologische und ultrastrukturelle Aspekte der Colitis ulcerosa. Schweiz Med Wochenschr 111: 768–773PubMedGoogle Scholar
  81. 81.
    Parks AG (1982) Die Rekonstruktion des Anus naturalis mittels Reservoir. Chirurg 53: 611–615PubMedGoogle Scholar
  82. 82.
    Pemberton JH, Beart RW, Hepell J, Dozois R, Telan-der RL (1982) Endorectal ileoanal anastomosis. Surg Gynecol Obstet 155: 417–424PubMedGoogle Scholar
  83. 83.
    Riddell RH, Morson BC (1979) Value of sigmoidoscopy and biopsy in detection of carcinoma and premalignant change in ulcerative colitis. Gut 1: 575–580CrossRefGoogle Scholar
  84. 84.
    Riemann JF (1982) Aetiologische Aspekte von M. Crohn und Colitis ulcerosa. In: Gall FP, Groitl H (eds) Entzündliche Erkrankungen des Dünn- und Dickdarmes. Perimed, ErlangenGoogle Scholar
  85. 85.
    Ritchie J, Lennard-Jones J (1978) Clinical outcome of the first ten years of ulcerative colitis and proctitis. Lancet 2: 1140–1143CrossRefGoogle Scholar
  86. 86.
    Roth JLA (1969) Ulcerative colitis. In: Bockus HL (ed) Gastroenterology. Saunders, Philadelphia, pp 645–749Google Scholar
  87. 87.
    Rothenberger DA, Vemevlen FD, Christenson CE, Balcos EG, Nemer FD, Goldberg S, Belliveau P, Nivatrongs S, Schottler JL, Kennedy HL, Fang DI (1983) Restorative proctocolectomy with ileal reser-voir and ileoanal anastomosis. Am J Surg 145: 82–88PubMedCrossRefGoogle Scholar
  88. 88.
    Säuberli H, Akovbiantz A, Hahnloser P (1982) Die chirurgische Behandlung der Colitis ulcerosa — Verbesserung der Lebensqualität durch kontinente Ileo-stomie? Extracta Gastroenterologica 11: 177–197Google Scholar
  89. 89.
    Säuberli H (1986) Colitis ulcerosa und M. Crohn -chirurgische Aspekte. Schweiz Rundschau Med (Praxis) 75: 283–289Google Scholar
  90. 90.
    Schofield PF, Manson JM (1986) Indications for and results of operation in inflammatory bowel disease. J R Soc Med 79: 593–595PubMedGoogle Scholar
  91. 91.
    Sigel A, Bötticher R, Supala K (1977) Urologische Komplikationen chronisch-entzündlicher Darmer-krankungen. Chirurg 48: 262–266PubMedGoogle Scholar
  92. 92.
    Stonnington CM, Phillips SF, Melton LJ, Zinsmeister AR (1987) Chronic ulcerative colitis: incidence and prevalence in a community. Gut 28: 402–409PubMedCrossRefGoogle Scholar
  93. 93.
    Surawicz CM (1987) Diagnosing colitis: biopsy is best. Gastroenterology 92: 538–540PubMedGoogle Scholar
  94. 94.
    Taylor BM, Beart RW (1983) Straight ileoanal anastomosis versus ileal pouch-anal anastomosis after colectomy and mucosal proctectomy. Arch Surg 118: 696–701PubMedCrossRefGoogle Scholar
  95. 95.
    Taylor BM, Beart RW, Dozois RR, Cranley B, Kelly KA, Phillips S F (1983) A clinico-physiological comparison of ileal pouch-anal and straight ileoanal anastomosis. Ann Surg 198: 462–468PubMedCrossRefGoogle Scholar
  96. 96.
    Truelove SC (1984) Ulcerative colitis. Update postgraduate centre series. Update, LondonGoogle Scholar
  97. 97.
    Turnbull RB (1970) Choice of operation for the toxic megacolon phase of nonspecific ulcerative colitis. Surg Clin N Am 50: 1151–1169PubMedGoogle Scholar
  98. 98.
    Van Heerden J, Mcllrath DC, Adson MA (1978) The surgical aspects of chronic mucosal inflammatory bowel disease. Ann Surg 187: 536–541PubMedCrossRefGoogle Scholar
  99. 99.
    Utsonomiya MD, Iwama T, Imajo M, Matsudo S, Sawai S, Yaegashi K, Hirayama R (1980) Total colectomy, mucosal proctectomy and ileoanal anastomosis. Dis Colon Rectum 23: 459–466CrossRefGoogle Scholar
  100. 100.
    Watkinson G (1973) Colitis ulcerosa. In: Demling L et al. (eds) Klinische Gastroenterologie. Thieme, StuttgartGoogle Scholar
  101. 101.
    Williams WS, Johnston D (1985) The current status of mucosal proctectomy and ileo-anal anastomosis in the surgical treatment of ulcerative colitis and adenomatous polyposis. Br J Surg 72: 159–168PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • H. Wehrli
  • A. Akovbiantz

There are no affiliations available

Personalised recommendations