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Original ArticleOpen Access
Ulcerative Colitis in Thailand: A Clinical Study and Long Term Follow-up
Pongprasobchai S 
,
Manatsathit S ,
Leelakusolvong S ,
Sattawatthamrong Y ,
Boonyapisit S
,
Manatsathit S ,
Leelakusolvong S ,
Sattawatthamrong Y ,
Boonyapisit S Ulcerative colitis (UC) is uncommon in Thailand. Few reports have been published and
confirmation of the diagnosis was difficult. To make a firm diagnosis of UC in Thailand, long-term
follow-up and demonstration of chronic and relapsing clinical courses should help to confirm the
existence of UC in Thailand.
Objective:
To review the demographic data, clinical presentation and clinical courses
of the diagnosed UC cases in Thailand.
Material and Method:
Diagnosed UC patients who were followed-up for longer than 3
months at the Diarrhea Clinic, Siriraj Hospital between 1988-2000 were included.
Results:
Forty cases of UC were followed-up. The duration of follow-up ranged from
3-75 months (mean 27 months). Male to female ratio was 19:21 and age of onset varied from 13-77
years (mean 37.7 years). Extents of the disease was left-sided colitis in 58 per cent, left and right-
sided colitis in 8 per cent, pancolitis in 21 per cent, proctosigmoiditis in 13 per cent and ileal
involvement in 8 per cent. At presentation, the disease was mild in 28 per cent, moderate in 60
per cent, severe in 13 per cent and fulminant in 2. Clinical presentations were diarrhea in 97.5
per cent, lower GI bleeding in 17.5 per cent, abdominal pain in 50 per cent, fever in 27.5 per cent,
weight loss in 62.5 per cent and extraintestinal manifestations in 20 per cent. Diagnoses were
made in all cases by sigmoidoscopy plus barium enema or colonoscopy and biopsies were taken
in all cases. Histologic findings supported the diagnoses in 69 per cent of cases. Seventy per cent
responded to sulfasalazine or 5-ASA with or without corticosteroid, but in 30 per cent, azathio-
prine was added for a period during the treatment. Clinical courses of the diseases were chronic
intermittent with remission and relapse in 44 per cent, chronic continuous activity without
remission in 27 per cent, single episode without relapse in 27 per cent and acute fulminating
course in 6 per cent. One patient died from fulminant pancolitis with colonic perforation. There
was no colonic cancer in our cases throughout the follow-up period.
*
Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University,
Bangkok 10700, Thailand.
1282
confirmation of the diagnosis was difficult. To make a firm diagnosis of UC in Thailand, long-term
follow-up and demonstration of chronic and relapsing clinical courses should help to confirm the
existence of UC in Thailand.
Objective:
To review the demographic data, clinical presentation and clinical courses
of the diagnosed UC cases in Thailand.
Material and Method:
Diagnosed UC patients who were followed-up for longer than 3
months at the Diarrhea Clinic, Siriraj Hospital between 1988-2000 were included.
Results:
Forty cases of UC were followed-up. The duration of follow-up ranged from
3-75 months (mean 27 months). Male to female ratio was 19:21 and age of onset varied from 13-77
years (mean 37.7 years). Extents of the disease was left-sided colitis in 58 per cent, left and right-
sided colitis in 8 per cent, pancolitis in 21 per cent, proctosigmoiditis in 13 per cent and ileal
involvement in 8 per cent. At presentation, the disease was mild in 28 per cent, moderate in 60
per cent, severe in 13 per cent and fulminant in 2. Clinical presentations were diarrhea in 97.5
per cent, lower GI bleeding in 17.5 per cent, abdominal pain in 50 per cent, fever in 27.5 per cent,
weight loss in 62.5 per cent and extraintestinal manifestations in 20 per cent. Diagnoses were
made in all cases by sigmoidoscopy plus barium enema or colonoscopy and biopsies were taken
in all cases. Histologic findings supported the diagnoses in 69 per cent of cases. Seventy per cent
responded to sulfasalazine or 5-ASA with or without corticosteroid, but in 30 per cent, azathio-
prine was added for a period during the treatment. Clinical courses of the diseases were chronic
intermittent with remission and relapse in 44 per cent, chronic continuous activity without
remission in 27 per cent, single episode without relapse in 27 per cent and acute fulminating
course in 6 per cent. One patient died from fulminant pancolitis with colonic perforation. There
was no colonic cancer in our cases throughout the follow-up period.
*
Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University,
Bangkok 10700, Thailand.
1282
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