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April 1957

The Treatment of Ulcerative Colitis

Author Affiliations


Department of Medicine, University of Chicago. Clinical Trainee, National Institute of Arthritis and Metabolic Diseases, U. S. Public Health Service (Dr. Bicks).

AMA Arch Intern Med. 1957;99(4):642-655. doi:10.1001/archinte.1957.00260040142014

Introduction  Ulcerative colitis is an acute and chronic disease of the colon and rectum, characterized clinically by bloody diarrhea, cramping abdominal pain, malaise, anorexia, fever, and weight loss.1,2 Proctoscopic examination of the rectum and sigmoid reveals, in approximately 95% of cases, diffuse inflammation, with edema, granularity, ulceration, and friability of the mucosa and sanguinopurulent exudation. Roentgen study demonstrates loss of normal haustration of the colon, decreased distensibility, narrowing and ulceration of the bowel, and pseudopolypoid changes in the mucosa. The entire colon and rectum appear involved roentgenologically in approximately 50% of cases; in perhaps 10% the x-ray appearance is normal, presumably owing to limitation of the process to the mucosa; in the remaining 40% varying portions of the bowel are diseased. The adjacent terminal ileum also is affected in 10% to 15% of patients.3 Ileocolitis involves chiefly the distal portion of the ileum, the cecum, and the ascending