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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis
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Appendicectomy as a therapy for ulcerative proctitis.

Terry Dorcen Bolin1, Shing Wong, Roger Crouch

  • 1Gastrointestinal and Liver Unit, Department of Medicine, The Prince of Wales Hospital, 201 Avoca Street, Randwick 2031, New South Wales, Sydney 2031, Australia. kerrie@terrybolin.com

The American Journal of Gastroenterology
|July 9, 2009
PubMed
Summary

Appendicectomy significantly improved ulcerative proctitis symptoms in 90% of patients, with 40% achieving complete remission. This suggests appendicectomy may be a viable treatment option for ulcerative proctitis.

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Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Inflammatory Bowel Disease Research

Background:

  • Limited data exists on appendicectomy's impact on ulcerative colitis (UC) clinical course.
  • Ulcerative proctitis, a subset of UC, affects the colon's distal part.
  • Appendicectomy is surgical removal of the appendix.

Purpose of the Study:

  • To investigate the effect of appendicectomy on the clinical course of ulcerative proctitis.
  • To assess symptom improvement and remission rates post-appendicectomy in UC patients.

Main Methods:

  • A prospective case series of 30 adult patients with ulcerative proctitis.
  • Patients underwent appendicectomy without prior appendicitis history.
  • Clinical follow-up included Simple Clinical Colitis Activity Index (SCCAI) assessment for a median of 14 months.

Main Results:

  • Appendicectomy led to significant SCCAI improvement (median score decreased from 9 to 2, P<0.0005).
  • 90% of patients (27/30) showed clinical improvement; 40% (12/30) achieved complete symptom resolution and drug withdrawal.
  • Complete remission was sustained for a median of 9 months; no clinical or histological factors predicted outcome.

Conclusions:

  • This study, the largest of its kind, suggests appendicectomy may positively modulate ulcerative proctitis.
  • Appendicectomy shows potential as a therapeutic option for ulcerative proctitis.
  • Further controlled trials are warranted to validate the role of appendicectomy in ulcerative proctitis treatment.