CHRONIC ULCERATIVE COLITIS—ALLERGY IN ITS ETIOLOGY

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Abstract
Evidence favoring allergy as an important fundamental cause of chronic ulcerative colitis is presented. The colonic lesions can be explained by the same mechanism as is responsible for atopic dermatitis due to food and inhalant allergy. Ulcerations may be due to complicating infection or to canker-like lesions due to vascular allergy. The degree of ulcerations and the latter mucosal denudation, fibrosis. constrictions, bleeding, or perforation may vary depending on the patient''s resistance to his bowel organisms, anemia, and avitaminosis. The control of food allergy gave excellent, relief in 7 cases and satisfactory relief in 3 of 15 cases studied. Relief varied according to cooperation. The duration of relief varied from I, to 4 yrs. Gain of wt. varied from 10 to 44 lbs. except for a loss of 10 lbs. in one well controlled patient. No remissions occurred. One patient with seasonal ulcerative colitis was controlled by pollen therapy. Of 4 remaining cases 1 died of perforation, 2 have had ileostomies with later colectomies with good results and 1 is still under observation. A fruit-free and cereal-free elimination diet was used for the study of possible food allergy. Skin tests were of no definite value. A history of familial or other personal allergy was not necessarily present. Relief from diet trial occurred in from 1-4 wks. When evidence of infection continues, sulfaguanidine is used with benefit and vit. therapy is also given when avitaminosis is indicated. When symptoms resist such therapy and when septicemia or perforation threatens, surgery should be considered. Such surgery, however, is not advisable until allergy, especially to foods, has been adequately studied.

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