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. 2018 Jun;34(3):138-143.
doi: 10.3393/ac.2017.06.08. Epub 2018 Jun 30.

Clinical Characteristics and Incidence of Perianal Diseases in Patients With Ulcerative Colitis

Yong Sung Choi  1 , Do Sun Kim  2 , Doo Han Lee  2 , Jae Bum Lee  2 , Eun Jung Lee  2 , Seong Dae Lee  2 , Kee Ho Song  2 , Hyung Joong Jung  2
Affiliations

Clinical Characteristics and Incidence of Perianal Diseases in Patients With Ulcerative Colitis

Yong Sung Choi et al. Ann Coloproctol. 2018 Jun.

Abstract

Purpose: While perianal disease (PAD) is a characteristic of patients with Crohn disease, it has been overlooked in patients with ulcerative colitis (UC). Thus, our study aimed to analyze the incidence and the clinical features of PAD in patients with UC.

Methods: We reviewed the data on 944 patients with an initial diagnosis of UC from October 2003 to October 2015. PAD was categorized as hemorrhoids, anal fissures, abscesses, and fistulae after anoscopic examination by experienced proctologists. Data on patients' demographics, incidence and types of PAD, medications, surgical therapies, and clinical course were analyzed.

Results: The median follow-up period was 58 months (range, 12-142 months). Of the 944 UC patients, the cumulative incidence rates of PAD were 8.1% and 16.0% at 5 and 10 years, respectively. The incidence rates of bleeding hemorrhoids, anal fissures, abscesses, and fistulae at 10 years were 6.7%, 5.3%, 2.6%, and 3.4%, respectively. The cumulative incidence rates of perianal sepsis (abscess or fistula) were 2.2% and 4.5% at 5 and 10 years, respectively. In the multivariate analyses, male sex (risk ratio [RR], 4.6; 95% confidence interval [CI], 1.7-12.5) and extensive disease (RR, 4.2; 95% CI, 1.6-10.9) were significantly associated with the development of perianal sepsis.

Conclusion: Although the clinical course of PAD in patients with UC is not serious, in clinical practice, PAD is not rare in such patients. Therefore, careful examination and appropriate management for PAD is needed if the quality of life for patients with UC is to be improved.

Keywords: Ulcerative colitis; Perianal disease.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Kaplan-Meier survival plot for the cumulative incidence of perianal disease (PAD) in patients with ulcerative colitis (n = 944).
Fig. 2.
Fig. 2.
Kaplan-Meier survival plots for the cumulative incidence of perianal sepsis in patients with ulcerative colitis according to sex (A) and extent of the disease (B).
See this image and copyright information in PMC

References

    1. Schwartz DA, Loftus EV, Jr, Tremaine WJ, Panaccione R, Harmsen WS, Zinsmeister AR, et al. The natural history of fistulizing Crohn’s disease in Olmsted County, Minnesota. Gastroenterology. 2002;122:875–80. - PubMed
    1. Fichera A, Michelassi F. Surgical treatment of Crohn’s disease. J Gastrointest Surg. 2007;11:791–803. - PubMed
    1. Tozer PJ, Whelan K, Phillips RK, Hart AL. Etiology of perianal Crohn’s disease: role of genetic, microbiological, and immunological factors. Inflamm Bowel Dis. 2009;15:1591–8. - PubMed
    1. Eglinton TW, Barclay ML, Gearry RB, Frizelle FA. The spectrum of perianal Crohn’s disease in a population-based cohort. Dis Colon Rectum. 2012;55:773–7. - PubMed
    1. Beaugerie L, Seksik P, Nion-Larmurier I, Gendre JP, Cosnes J. Predictors of Crohn’s disease. Gastroenterology. 2006;130:650–6. - PubMed

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