Background: Ulcerative colitis is an inflammatory bowel disease that can cause serious complications or death if treatment is delayed. This study aimed to identify clinical and paraclinical indicators of severe ulcerative colitis. Materials and Methods: This cross-sectional study was conducted on all UC patients referred to a gastrointestinal clinic in Bandar Abbas, Iran, from June 2021 to June 2022. UC diagnosis was established based on clinical, paraclinical, and endoscopic criteria. Patients were categorized into three groups based on disease extension: proctitis, left-sided colitis, and pancolitis. Disease activity was assessed using the Ulcerative Colitis Endoscopic Index of Severity (UCEIS), where scores indicated remission (0-1), mild (2-4), moderate (5-6), or severe (7-8) activity. Results: This study involved 299 UC patients with a mean age of 38.3±12.8 years (range: 14-73), comprising 139 males (46.5%) and 160 females (53.5%). Multiple logistic regression revealed that infant formula feeding was linked to a lower risk of severe UC (OR=0.446, 95% CI=0.208, 0.952, P=0.037). Independent markers of severe UC included a history of targeted immunotherapies (P=0.003), bloody diarrhea (P=0.006), abdominal pain (P=0.041), fecal calprotectin (P=0.017), and ESR (P<0.001). Additionally, targeted immunotherapies (P=0.002), abdominal pain (P=0.009), fecal calprotectin (P=0.034), and CRP (P=0.013) were associated with greater colon involvement in UC. Conclusion: It can be concluded that concurrent elevation of fecal calprotectin and ESR levels may indicate more severe manifestations of the disease, while simultaneous increases in fecal calprotectin and CRP may indicate broader involvement of the bowel in UC.
Basham et al. (Tue,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: