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Ulcerative Colitis

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Anorectal and Colonic Diseases

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Abstract

Bloody diarrhoea is the hallmark of acute ulcerative colitis (UC), which in most patients runs a clinical course that is characterised by unpredictable relapses interspersed with periods of remission. It can be defined as continuous mucosal inflammation of the colon without granulomas on biopsy affecting the rectum and a variable extent of the colon in continuity. Diagnostic precision is essential. The diagnosis should define the distribution and pattern of disease, because this influences treatment of both the active phase and maintenance of remission. Review of the diagnosis is fundamental when dealing with refractory symptoms or when considering surgical intervention. The potential to predict the pattern of the disease at diagnosis, or to deploy pharmacogenetics in tailoring treatment to an individual is immensely exciting. Nevertheless, technology will never remove the need for an empathetic clinician, who must first take the clinical history of miserable symptoms in a sensitive manner.

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References

  1. Stange EF, Travis SPL, Vermeire S, et al; for the European Crohn’s and Colitis Organisation (ECCO). European evidence-based Consensus on the diagnosis and management of ulcerative colitis: definitions and diagnosis. J Crohns Colitis 2008; 2:1–23

    Article  Google Scholar 

  2. Travis SPL, Stange EF, Lémann M, et al; for the European Crohn’s and Colitis Organisation (ECCO). European evidence-based consensus on the management of ulcerative colitis: current management. J Crohns Colitis 2008; 2:24–62

    Article  Google Scholar 

  3. Biancone L, Michetti P, Travis S, et al; for the European Crohn’s and Colitis Organisation (ECCO). European evidence-based consensus on the management of ulcerative colitis: special situations. J Crohns Colitis 2008; 2:63–92

    Article  Google Scholar 

  4. Edwards FC, Truelove SC. The course and prognosis of ulcerative colitis. Gut 1963; 4:299–315

    Article  CAS  PubMed  Google Scholar 

  5. Lennard-Jones JE, Shivananda S, EC-IBD Study Group. Clinical uniformity of inflammatory bowel disease at presentation and during the first year of disease in the north and south of Europe. Eur J Gastroenterol Hepatol 1997; 9:353–359

    CAS  PubMed  Google Scholar 

  6. Riegler G, Tartaglione MT, Carratu R, et al. Age-related clinical severity at diagnosis in 1705 patients with ulcerative colitis. Dig Dis Sci 2000; 45:462–465

    Article  CAS  PubMed  Google Scholar 

  7. Blomberg B, Järnerot G. Clinical evaluation and management of acute severe colitis. Inflamm Bowel Dis 2000; 6:214–227

    CAS  PubMed  Google Scholar 

  8. Pera A, Bellando P, Caldera D, et al. Colonoscopy in inflammatory bowel disease: diagnostic accuracy and proposal of an endoscopic score. Gastroenterology 1987; 92:181–185

    CAS  PubMed  Google Scholar 

  9. D’Haens G, Gebboes K, Peeters M, et al. Patchy cecal inflammation associated with distal ulcerative colitis: a prospective endoscopic study. Am J Gastroenterol 1997; 92:1275–1279

    PubMed  Google Scholar 

  10. Velayos FS, Loftus EV Jr, Jess T, et al. Predictive and protective factors associated with colorectal cancer in ulcerative colitis: a case-control study. Gastroenterology 2006; 130:1941–1949

    Article  PubMed  Google Scholar 

  11. Jenkins D, Balsitis M, Gallivan S, et al. Guidelines for the initial biopsy diagnosis of suspected chronic idiopathic inflammatory bowel disease. The British Society of Gastroenterology Initiative. J Clin Pathol 1997; 50:93–105

    Article  CAS  PubMed  Google Scholar 

  12. Levine TS, Tzardi M, Mitchell S, et al. Diagnostic difficulty arising from rectal recovery in ulcerative colitis. J Clin Pathol 1997; 50:354–355

    Google Scholar 

  13. Silverberg MS, Satsangi J, Ahmad T, et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a working party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol 2005; 19:5A–36A

    Google Scholar 

  14. Price AB. Overlap in the spectrum of non-specific inflammatory bowel disease – ‘colitis indeterminate’. J Clin Pathol 1978; 31:567–577

    Article  CAS  PubMed  Google Scholar 

  15. D’Haens G, Sandborn WJ, Feagan B, et al. A review of activity indices and efficacy endpoints for clinical trials of medical therapy in adults with ulcerative colitis. Gastroenterology 2007; 132:763–786

    Article  PubMed  CAS  Google Scholar 

  16. Truelove SC, Witts LJ. Cortisone in ulcerative colitis: final report on a therapeutic trial. Br Med J 1955; 2:1041–1045

    Article  CAS  PubMed  Google Scholar 

  17. Travis SPL, Farrant JM, Ricketts C, et al. Predicting outcome in severe ulcerative colitis. Gut 1996; 38:905–910

    Article  CAS  PubMed  Google Scholar 

  18. Lennard Jones JE, Ritchie JK, Hilder W, et al. Assessment of severity in colitis: a preliminary study. Gut 1975; 16:579–584

    Article  CAS  PubMed  Google Scholar 

  19. Chew CN, Nolan DJ, Jewell DP. Small bowel gas in severe ulcerative colitis. Gut 1991; 32:1535–1537

    Article  CAS  PubMed  Google Scholar 

  20. Van Bodegraven AA, Boer RO, Lourens J, et al. Distribution of mesalazine enemas in active and quiescent ulcerative colitis. Aliment Pharmacol Ther 1996;10:327–332

    Article  PubMed  Google Scholar 

  21. Marshall JK, Irvine EJ. Rectal corticosteroids versus alternative treatment in ulcerative colitis: a meta-analysis. Gut 1997; 40:775–781

    Article  CAS  PubMed  Google Scholar 

  22. Gionchetti P, Rissole F, Ventura A, et al. Comparison of mesalazine suppositories in proctitis and distal proctosigmoiditis. Aliment Pharmacol Ther 1997;11:1053–1057

    Article  CAS  PubMed  Google Scholar 

  23. Cohen RD, Woseth DM, Thisted RA, et al. A meta-analysis and overview of the literature on treatment options for left-sided ulcerative colitis and ulcerative proctitis. Am J Gastroenterol 2000; 95:1263–1276

    Article  CAS  PubMed  Google Scholar 

  24. Travis SPL. Refractory distal colitis. In: Jewell DP, Mortensen NJM, Steinhart H, Warren BF, Pemberton J (eds) Challenges in Inflammatory Bowel Disease, 2nd edn. Blackwell Science, Oxford, 2006; pp 124–143

    Google Scholar 

  25. Carter MJ, Lobo AJ, Travis SPL, et al. Guidelines for the management of inflammatory bowel disease in adults. Gut 2004; 53:V1–16

    Article  PubMed  Google Scholar 

  26. Safdi M, DeMicco M, Sninsky C, et al. A double-blind comparison of oral versus rectal mesalazine versus combination therapy in the treatment of ulcerative colitis. Am J Gastrol 1998; 92:1867–1871

    Google Scholar 

  27. Bebb JR, Scott BB. Systematic review: how effective are the usual treatments for ulcerative colitis? Aliment Pharmacol Ther 2004; 20:143–149

    Article  CAS  PubMed  Google Scholar 

  28. Travis SPL. Dose escalation of 5ASA: does it work? Dig Liver Dis 2005; 37:82–84

    Article  CAS  PubMed  Google Scholar 

  29. Brain AO, Travis SPL. Therapy of ulcerative colitis: state of the art. Curr Opin Gastroenterol 2008; 24:469–474

    Article  CAS  PubMed  Google Scholar 

  30. Marteau P, Probert CS, Lindgren S, et al. Combined oral and enema treatment with Pentasa (mesalazine) is superior to oral therapy alone in patients with extensive mild/moderate active ulcerative colitis: a randomised, double blind, placebo controlled study. Gut 2005; 54:960–965

    Article  CAS  PubMed  Google Scholar 

  31. Jakobovits S, Travis SPL. Management of acute severe colitis. Br Med Bull 2006; 75–76:131–144

    Article  PubMed  Google Scholar 

  32. Travis SPL. Predicting outcome in severe ulcerative colitis. Dig Liver Dis 2004; 36:448–450

    Article  CAS  PubMed  Google Scholar 

  33. Lindgren SC, Flood LM, Kilander AF, et al. Early predictors of glucocorticoid treatment failure in severe and moderately severe attacks of ulcerative colitis. Eur J Gastroenterol Hepatol 1998; 10:831–835

    CAS  PubMed  Google Scholar 

  34. Van Assche G, D’Haens G, Noman M, et al. Randomized, double-blind comparison of 4 mg/kg versus 2 mg/kg intravenous cyclosporine in severe ulcerative colitis. Gastroenterology 2003; 125:1025–1031

    Article  PubMed  Google Scholar 

  35. Campbell S, Travis SPL, Jewell DP. Ciclosporin use in acute ulcerative colitis: a long-term experience. Eur J Gastroenterol Hepatol 2005; 17:79–84

    Article  CAS  PubMed  Google Scholar 

  36. Arts J, D’Haens G, Zeegers M, et al. Long-term outcome of treatment with intravenous cyclosporin in patients with severe ulcerative colitis. Inflamm Bowel Dis 2004; 10:73–78

    Article  PubMed  Google Scholar 

  37. Poritz LS, Rowe WA, Swenson BR, et al. Intravenous cyclosporine for the treatment of severe steroid refractory ulcerative colitis: what is the cost? Dis Colon Rectum 2005; 48:1685–1690

    Article  PubMed  Google Scholar 

  38. Hyde GM, Jewell DP, Kettlewell MGW, et al. Cyclosporin for severe ulcerative colitis does not increase the rate of perioperative complications. Dis Colon Rectum 2001; 44:1436–1440

    Article  CAS  PubMed  Google Scholar 

  39. Järnerot G, Hertervig E, Friis-Liby I, et al. Infliximab as rescue therapy in severe to moderately severe ulcerative colitis: a randomized, placebo-controlled study. Gastroenterology 2005; 128:1805–1811

    Article  PubMed  CAS  Google Scholar 

  40. Rutgeerts P, Sandborn WJ, Feagan B, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 2005; 233:2462–2473

    Article  Google Scholar 

  41. Travis SPL. Saving the colon in severe colitis. Alim Pharmacol Ther 2006; 24:68–73

    Article  CAS  Google Scholar 

  42. Langholz E, Munkholm P, Davidsen M, et al. Course of ulcerative colitis: analysis of changes in disease activity over years. Gastroenterology 1994; 107:3–11

    CAS  PubMed  Google Scholar 

  43. Meucci G, Vecchi M, Astegiano M, et al. The natural history of ulcerative proctitis: a multicenter, retrospective study. Am J Gastroenterol 2000; 95:469–473

    Article  CAS  PubMed  Google Scholar 

  44. Edwards FC, Truelove SC. The course and prognosis of ulcerative colitis. Gut 1963; 4:299–315

    Article  CAS  PubMed  Google Scholar 

  45. Sutherland L, Roth D, Beck P, et al. Oral 5-aminosalicylic acid for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev 2002; 4:CD000544

    PubMed  Google Scholar 

  46. Marteau P, Crand J, Foucault M, et al. Use of mesalazine slow-release suppositories 1g three times per week to maintain remission of ulcerative proctitis: a randomised double-blind placebo-controlled multicentre study. Gut 1998; 42:195–199

    Article  CAS  PubMed  Google Scholar 

  47. van Staa TP, Travis SPL, Leufkens HJM, et al. 5-Aminosalicylic acids and the risk of renal disease: a large British epidemiological study. Gastroenterology 2004; 126:1733–1739

    Article  PubMed  CAS  Google Scholar 

  48. Kane S, Huo D, Aikens J, Hanauer S. Medication nonadherence and the outcomes of patients with quiescent ulcerative colitis. Am J Med 2003; 114:39–43

    Article  PubMed  Google Scholar 

  49. Kane S, Huo D, Magnanti K. A pilot feasibility study of once daily versus conventional dosing mesalamine for maintenance of ulcerative colitis. Clin Gastroenterol Hepatol 2003; 1:170–173

    Article  CAS  PubMed  Google Scholar 

  50. Ardizzone S, Maconi G, Russo A, et al. Randomised controlled trial of azathioprine and 5-aminosalicylic acid for treatment of steroid-dependent ulcerative colitis. Gut 2006; 55:47–53

    Article  CAS  PubMed  Google Scholar 

  51. Travis SPL. Immunomodulator therapy: state of the art in accordance with guidelines. In: Rachmilewitz D, Dignass A, Stange EF, Weinstock JV (eds) Proceedings of the Falk Symposium No. 153, Immunoregulation in Inflammatory Bowel Diseases. Kluwer Academic, Dordrecht, 2007; pp 73–85

    Google Scholar 

  52. Eaden JA, Abrams K, Mayberry JF. The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut 2001; 48:526–535

    Article  CAS  PubMed  Google Scholar 

  53. Winther KV, Jess T, Langholz E, et al. Long-term risk of cancer in ulcerative colitis: a population-based cohort study from Copenhagen County. Clin Gastroenterol Hepatol 2004; 2:1088–1095

    Article  PubMed  Google Scholar 

  54. Rousseaux C, Lefebvre B, Dubuquoy L, et al. Intestinal anti-inflammatory effect of 5-aminosalicylic acid is dependent on peroxisome proliferator-activated receptor-gamma. J Exp Med 2005; 201:1205–1215

    Article  CAS  PubMed  Google Scholar 

  55. Velayos FS, Terdiman JP, Walsh JM. Effect of 5-aminosalicylate use on colorectal cancer and dysplasia risk: a systematic review and meta-analysis of observational studies. Am J Gastroenterol 2005; 100:1345–1353

    Article  CAS  PubMed  Google Scholar 

  56. Eaden JA, Mayberry JF. Guidelines for screening and surveillance of asymptomatic colorectal cancer in patients with inflammatory bowel disease. Gut 2002; 51:V10–V2 (being updated in 2007)

    Article  PubMed  Google Scholar 

  57. Rutter MD, Saunders BP, Wilkinson KH, et al. Thirty-year analysis of a colonoscopic surveillance programme for neoplasia in ulcerative colitis. Gastroenterology 2006;130:1030–1038

    Article  PubMed  Google Scholar 

  58. Bernstein CN. Natural history and management of flat and polypoid dysplasia in inflammatory bowel disease. Gastroenterol Clin North Am 2006; 35:573–579

    Article  PubMed  Google Scholar 

  59. Lim CH, Dixon MF, Vail A, et al. Ten year follow up of ulcerative colitis patients with and without low grade dysplasia. Gut 2003; 52:1127–1132

    Article  CAS  PubMed  Google Scholar 

  60. Rubio CA, Befrits R. Low-grade dysplasia in flat mucosa in ulcerative colitis. Gastroenterology 2004; 126:1494; author reply 1494–1495

    Article  CAS  PubMed  Google Scholar 

  61. Parks AG, Nicholls RJ. Proctocolectomy without ileostomy for ulcerative colitis. Br Med J 1978; 2:85–88

    Article  CAS  PubMed  Google Scholar 

  62. Delaney CP, Fazio VW, Remzi FH, et al. Prospective, age-related analysis of surgical results, functional outcome, and quality of life after ileal pouch–anal anastomosis. Ann Surg 2003; 238:221–228

    PubMed  Google Scholar 

  63. Yu CS, Pemberton JH, Larson D. Ileal pouch–anal anastomosis in patients with indeterminate colitis: long-term results. Dis Colon Rectum 2000; 43:1487–496

    Article  CAS  PubMed  Google Scholar 

  64. Delaney CP, Remzi FH, Gramlich T, et al. Equivalent function, quality of life and pouch survival rates after ileal pouch–anal anastomosis for indeterminate and ulcerative colitis. Ann Surg 2002; 236:43–48

    Article  PubMed  Google Scholar 

  65. Regimbeau JM, Panis Y, Pocard M, et al. Long-term results of ileal pouch–anal anastomosis for colorectal Crohn’s disease. Dis Colon Rectum 2001; 44:769–778

    Article  CAS  PubMed  Google Scholar 

  66. Miller R, Bartolo DC, Orrom WJ, et al. Improvement of anal sensation with preservation of the anal transition zone after ileoanal anastomosis for ulcerative colitis. Dis Colon Rectum 1990; 33:414–418

    Article  CAS  PubMed  Google Scholar 

  67. Thompson-Fawcett MW, Warren BF, Mortensen NJ. A new look at the anal transitional zone with reference to restorative proctocolectomy and the columnar cuff. Br J Surg 1998; 85:1517–1521

    Article  CAS  PubMed  Google Scholar 

  68. Williamson ME, Lewis WG, Sagar PM, et al. One-stage restorative proctocolectomy without temporary ileostomy for ulcerative colitis: a note of caution. Dis Colon Rectum 1997; 40:1019–1022

    Article  CAS  PubMed  Google Scholar 

  69. Ky AJ, Sonoda T, Milsom JW. One stage laparoscopic restorative proctocolectomy: an alternative to the conventional approach? Dis Colon Rectum 2002; 45:207–210

    Article  PubMed  Google Scholar 

  70. Fazio VW, Tekkis PP, Remzi F, et al. Quantification of risk for pouch failure after ileal pouch anal anastomosis surgery. Ann Surg 2003; 238:605–614; discussion 614–617

    PubMed  Google Scholar 

  71. MacRae HM, McLeod RS, Cohen Z, et al. Risk factors for pelvic pouch failure. Dis Colon Rectum 1997; 40:257–262

    Article  CAS  PubMed  Google Scholar 

  72. MacLean AR, Cohen Z, MacRae HM, et al. Risk of small bowel obstruction after the ileal pouch–anal anastomosis. Ann Surg 2002; 235:200–206

    Article  PubMed  Google Scholar 

  73. Heriot AG, Tekkis PP, Smith JJ, et al. Management and outcome of pouch–vaginal fistulas following restorative proctocolectomy. Dis Colon Rectum 2005; 48:451–458

    Article  PubMed  Google Scholar 

  74. Senapati A, Tibbs CJ, Ritchie JK, et al. Stenosis of the pouch anal anastomosis following restorative proctocolectomy. Int J Colorectal Dis 1996; 11:57–59

    Article  CAS  PubMed  Google Scholar 

  75. Lindsey I, George BD, Kettlewell MG, et al. Impotence after mesorectal and close rectal dissection for inflammatory bowel disease. Dis Colon Rectum 2001; 44:831–835

    Article  CAS  PubMed  Google Scholar 

  76. Lindsey I, George B, Kettlewell M, et al. Randomized, double-blind, placebo-controlled trial of sildenafil (Viagra) for erectile dysfunction after rectal excision for cancer and inflammatory bowel disease. Dis Colon Rectum 2002; 45:727–732

    Article  PubMed  Google Scholar 

  77. Ording Olsen K, Juul S, Berndtsson I, et al. Ulcerative colitis: female fecundity before diagnosis, during disease, and after surgery compared with a population sample. Gastroenterology 2002; 122:15–19

    Article  PubMed  Google Scholar 

  78. Remzi FH, Gorgun E, Bast J, et al. Vaginal delivery after ileal pouch–anal anastomosis: a word of caution. Dis Colon Rectum 2005; 48:1691–1699

    Article  PubMed  Google Scholar 

  79. Ravid A, Richard CS, Spencer LM, et al. Pregnancy, delivery, and pouch function after ileal pouch–anal anastomosis for ulcerative colitis. Dis Colon Rectum 2002; 45:1283–1288

    Article  CAS  PubMed  Google Scholar 

  80. MacLean AR, O’Connor B, Parkes R, et al. Reconstructive surgery for failed ileal pouch–anal anastomosis: a viable surgical option with acceptable results. Dis Colon Rectum 2002; 45:880–886

    Article  PubMed  Google Scholar 

  81. Herbst F, Sielezneff I, Nicholls RJ. Salvage surgery for ileal pouch outlet obstruction. Br J Surg 1996; 83:368–371

    Article  CAS  PubMed  Google Scholar 

  82. Fazio VW, Wu JS, Lavery IC. Repeat ileal pouch–anal anastomosis to salvage septic complications of pelvic pouches: clinical outcome and quality of life assessment. Ann Surg 1998; 228: 588–597

    Article  CAS  PubMed  Google Scholar 

  83. Karoui M, Cohen R, Nicholls J. Results of surgical removal of the pouch after failed restorative proctocolectomy. Dis Colon Rectum 2004; 47:869–875

    Article  PubMed  Google Scholar 

  84. Shen B, Lashner BA, Bennett AE, et al. Treatment of rectal cuff inflammation (cuffitis) in patients with ulcerative colitis following restorative proctocolectomy and ileal pouch–anal anastomosis. Am J Gastroenterol 2004; 99:1527–1531

    Article  PubMed  Google Scholar 

  85. Stahlberg D, Gullberg K, Liljeqvist L, et al. Pouchitis following pelvic pouch operation for ulcerative colitis. Incidence, cumulative risk, and risk factors. Dis Colon Rectum 1996; 39:1012–1018

    Article  CAS  PubMed  Google Scholar 

  86. Hurst RD, Molinari M, Chung TP, et al. Prospective study of the incidence, timing and treatment of pouchitis in 104 consecutive patients after restorative proctocolectomy. Arch Surg 1996; 131:497–500; discussion 501–502

    CAS  PubMed  Google Scholar 

  87. Lepisto A, Luukkonen P, Jarvinen HJ. Cumulative failure rate of ileal pouch anal anastomosis and quality of life after failure. Dis Colon Rectum 2002; 45:1289–1294

    Article  PubMed  Google Scholar 

  88. Lim M, Sagar P, Finan P, et al. Dysbiosis and pouchitis Br J Surg 2006; 93:1325–1334

    Article  CAS  PubMed  Google Scholar 

  89. Madden MV, McIntyre AS, Nicholls RJ. Double-blind crossover trial of metronidazole versus placebo in chronic unremitting pouchitis. Dig Dis Sci 1994; 39:1193–1196

    Article  CAS  PubMed  Google Scholar 

  90. Gionchetti P, Rizzello F, Helwig U, et al. Prophylaxis of pouchitis onset with probiotic thrapy: a double-blind, placebo controlled trial. Gastroenterology 2003; 124:1202–1209

    Article  PubMed  Google Scholar 

  91. Thompson-Fawcett MW, Mortensen NJ, Warren BF. “Cuffitis” and inflammatory changes in the columnar cuff, anal transitional zone, and ileal reservoir after stapled pouch–anal anastomosis. Dis Colon Rectum 1999; 42:348–355

    Article  CAS  PubMed  Google Scholar 

  92. Remzi FH, Fazio VW, Delaney CP et al. Dysplasia of the anal transitional zone after ileal pouch–anal anastomosis: results of prospective evaluation after a minimum of ten years. Dis Colon Rectum 2003; 46:6–13

    Article  PubMed  Google Scholar 

  93. Bullard KM, Madoff RD, Gemlo BJ. Is ileoanal pouch function stable with time? Results of a prospective audit. Dis Colon Rectum 2002; 45:299–304

    Article  PubMed  Google Scholar 

  94. Mutinga ML, Odze RD, Wang HH, et al. The clinical significance of right-sided colonic inflammation in patients with left-sided chronic ulcerative colitis. Inflamm Bowel Dis 2004; 10:215–219

    Article  PubMed  Google Scholar 

  95. Subramanian V, Pollok RC, Kang JY, et al. Systematic review of postoperative complications in patients with inflammatory bowel disease treated with immunomodulators. Br J Surg 2006; 93:793–799

    Article  CAS  PubMed  Google Scholar 

  96. Oresland T, Palmblad S, Ellstrom M, et al. Gynaecological and sexual function related to anatomical changes in the female pelvis after restorative proctocolectomy. Int J Colorectal Dis 1994; 9:77–81

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Gastroenterology Unit, The John Radcliffe Hospital, OX3 9DU, Headington, Oxford, UK

    Simon Travis

  2. Department of Colorectal Surgery, The John Radcliffe Hospital, OX3 9DU, Headington, Oxford, UK

    Neil Mortensen

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  1. Simon Travis
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  1. Service de Chirurgie Viscérale, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland

    Jean-Claude R. Givel

  2. Department of Colorectal Surgery, The John Radcliffe Hospital, OX3 9DU, Headington, Oxford, UK

    Neil Mortensen

  3. Responsable de l’Unité de Proctologie, Hôpital Cantonal Universitaire de Genève, Rue Gabrielle Perret-Gentil 4, 1211, Genève 14, Switzerland

    Bruno Roche

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Travis, S., Mortensen, N. (2010). Ulcerative Colitis. In: Givel, JC., Mortensen, N., Roche, B. (eds) Anorectal and Colonic Diseases. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69419-9_31

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