Long-term follow-up of ulcerative colitis in Taiwan

The incidence of ulcerative colitis (UC) has been increasing in Asia recently, but little long-term follow-up data is available. We aimed to understand the clinical characteristics of UC patients in the National Taiwan University Hospital (NTUH), a tertiary referral center in Taiwan.

A retrospective study was conducted to review data from January 1, 1988 through December 31, 2008 compiled at NTUH. Patients' clinical information, demographic data, endoscopic pictures, treatment regimens, pathologic, and outcome details were reviewed, recorded, and analyzed.

A total of 406 patients were included (233 males and 173 females; median age at diagnosis was 36 years). The follow-up period ranged from 0.25 to 40.8 (mean, 7.3) years. The prevalence of UC in Taiwan was at least 7.4/100,000 in 2008. Bloody stool was the most common presentation (77.3%). Total colon was the most common (41.0%) disease involvement and proctitis the least common (21.1%). Six patients (1.5%) died during the follow up. Most of the UC patients (72.4%) could be controlled with 5-aminosalicylic acid alone, but about one third (30.9%) were admitted for treating the UC or UC-related complications. Twenty-three patients (5.5%) were treated surgically. Extra-gastrointestinal tract manifestations were noted in 4.5% of the UC patients, with primary sclerosing cholangitis (6 in 406, 1.5%) the most common. Colon cancer/severe dysplasia occurred in six (1.5%) of the patients.

The incidence of UC has increased in Taiwan. Interestingly, CRC/dysplasia and PSC occur more frequently here than in other Asian nations.