Prognostic indicators and clinical course in proctosigmoiditis

The progress and outcome of proctosigmoiditis (PS) varies from a benign self limited illness to severe or continuous disease which may require major surgery. This study identifies certain clinical features in the presenting attack which appear to influence the subsequent course of the disease. Ninety-nine patients with PS were referred to a colitis clinic between 1975 and 1985. Sixty have been followed for at least five years or have required surgery. They have been classified as follows. Group A-asymptomatic after presenting attack (n = 14), group B-symptoms after presenting attack for less than 10% of follow-up (n = 25), group C symptoms for greater than 10% of follow-up (n = 11), group D - patients requiring surgical intervention (n = 10). Data obtained during the initial attack, including sex, age, length of history, disease extent, length of first attack and therapy, were analysed. There was no significant difference in the length of history or extent of disease between groups. The mean ages in groups A-D were 40, 45, 30 and 24 years respectively. The ages of groups A and B were not significantly different, but differed from group C (p less than 0.05) and from group D (p less than 0.005). The length of the first attack was significantly shorter (p less than 0.01) in groups A and B (median 1.0 and 3.0 months respectively) than in groups C and D (median 5.0 and 6.0 months respectively).