Ulcerative colitis confined to the rectum and sigmoid flexure

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Abstract
Summary Ulcerative colitis confined to the rectum and sigmoid flexure was studied in 124 patients who had normal roentgenograms of the colon. Follow-up information on 120 patients was obtained; 63 were followed for periods longer than five years, the mean period being 6.2 years. The major symptom was rectal bleeding, which was the primary complaint of all but one patient. Sigmoidoscopic findings were indistinguishable from those of ulcerative colitis affecting more extensive portions of the colon. Biopsy specimens of rectal mucosa of 21 patients were indistinguishable from those of patients with ulcerative colitis. (No case of Crohn's disease was included in the study.) Extension to more proximal portions of the colon occurred in 20 patients and the entire colon was involved in 14. Ten patients required operations, of which three were abdominoperineal resections with colostomy; five were surgical procedures for toxic ulcerative colitis, and two were for carcinoma. No patient required surgical treatment solely for chronic symptoms of colitis. Ulcerative colitis confined to the rectum and sigmoid flexure is more benign and has a better prognosis than colitis involving the entire colon.