It has been 80 years since idiopathic ulcerative colitis was first identified as a clinical entity by Wilks and Moxon.1 Since their classic description in 1875, many attractive theories concerning the etiology of this disease have been advanced. In spite of extensive investigation, the cause of ulcerative colitis remains unknown. Medical management, therefore, is empirical and is directed toward control of the disease, alleviation of the psychosomatic agitants, and the recognition and handling of secondary complications. Nonoperative therapy is successful in the relatively mild cases of ulcerative colitis. It has permitted more adequate preparation of those patients requiring surgery; hence, both surgical mortality and morbidity have been reduced. By controlling the acute exacerbations of the disease, medical management has made urgent operation for the control of these exacerbations less frequent.
For those patients who continue to harbor an active, though chronic, ulcerative colitis, in spite of medical management, surgery
HILL LD, STONE CS, PEARSON CC. Surgical Aspects of Ulcerative ColitisAbdominal Proctocolectomy. AMA Arch Surg. 1956;72(6):968-976. doi:10.1001/archsurg.1956.01270240080012