[Treatment of hemorrhagic rectocolitis]

Ulcerative colitis (UC) is a chronic inflammatory disease usually localized to the mucosa of the rectum and colon. Its cause remains unknown. A few fundamental notions underlie the therapeutic approach: (1) UC generally evolves by acute episodes separated by remissions, and the therapeutic indications depend on the severity and periodicity of these acute episodes; (2) although UC is a usually benign disease it may kill in two circumstances: when a severe (or complicated) acute episode is operated belatedly, or when cancer of the colon develops; (3) the present medical treatment only has a suspensive effect on the disease; the maintenance treatment must be taken for life; (4) only total proctocolectomy can provide complete cure, and until recently this procedure required permanent ileostomy. The recently introduced ileo-anal anastomosis (after total colectomy and rectal mucosectomy) gives the same results and enable the natural anus to be spared.