The long term outcome of a cohort of Sri Lankan patients with ulcerative colitis at two tertiary care hospitals: preliminary results

Abstract

INTRODUCTION AND OBJECTIVES: Inflammatory bowel disease, especially ulcerative colitis (UC), is increasing in many 'non-western' populations. Although clinical impressions are that UC has a mild clinical course in these populations, long term outcomes have been poorly studied. Methods: In this ongoing retrospective cohort study conducted at the Gastroenterology clinics of the Colombo North Teaching hospital and the National Hospital of Sri Lanka, patients diagnosed with ulcerative colitis (UC) were assessed for 3 outcomes: colectomy, development of colorectal carcinoma and death. Registered patients not attending the clinic during the past 4 weeks or their families were contacted by telephone to obtain clinical details and survival status. The cause of death was confirmed from clinical records and death certificates. RESULTS: Of 414 registered patients with UC, to date, details of 274 (66%) (mean age 44.9 (SD 13.6) years, M:F =1:1.13) were available for analysis. The mean duration of follow up was 6.8 (SD 6.5) years. Cumulative rates for colectomy, colorectal carcinoma and death were 3.3%, 1.1% and 1.1% respectively. At 1, 5, 10 and 15 years, cumulative cancer free survival proportions were 0.99, 0.99, 0.99 and 0.98, cumulative colectomy free survival proportions were 0.99 0.96, 0.96 and 0.96, and cumulative survival proportions were 0.99, 0.99, 0.98 and 0.98 respectively. The proportions of patients who had none of these three outcomes were 0.98, 0.95, 0.93 and 0.92. CONCLUSIONS: In this cohort of Sri Lankan patients with UC, rates of colectomy, colorectal carcinoma and death were rare, indicating a benign disease course.