Ulcerative Colitis: Dead or Alive
Authors: David B. Sachar
Journal: Annals of Internal Medicine (2015)

Editorials18 August 2015Ulcerative Colitis: Dead or AliveDavid B. Sachar, MDDavid B. Sachar, MDFrom The Mount Sinai Medical Center, New York, New York.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1190 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail When we treat patients, what constitutes "success"? Only rarely is the criterion "cure." With few exceptions, such as some cancer cases and infections, internists rarely cure anything. Consider such chronic conditions as diabetes, asthma, hypertension, or rheumatoid arthritis—we cannot cure them, but we can control them to enable patients to lead longer lives of higher quality.But what is "high quality of life", and how do we measure it? There are a plethora of "quality-of-life" assays, including quantitative methods that allow one to calculate health-related quality of life (1). Many of these indices have been specifically devised for application to ...References1. Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA. 1995;273:59-65. [PMID: 7996652] CrossrefMedlineGoogle Scholar2. Alrubaiy L, Rikaby I, Dodds P, Hutchings HA, Williams JG. Systematic review of health-related quality of life measures for inflammatory bowel disease. J Crohns Colitis. 2015;9:284-92. [PMID: 25576752] doi:10.1093/ecco-jcc/jjv002 CrossrefMedlineGoogle Scholar3. Bewtra M, Newcomb CW, Wu Q, Chen L, Xie F, Roy JA, et al. Mortality associated with medical therapy versus elective colectomy in ulcerative colitis. A cohort study. Ann Intern Med. 2015;1:262-70. doi:10.7326/M14-0960 LinkGoogle Scholar4. Bewtra M, Kilambi V, Fairchild AO, Siegel CA, Lewis JD, Johnson FR. Patient preferences for surgical versus medical therapy for ulcerative colitis. Inflamm Bowel Dis. 2014;20:103-14. [PMID: 24280881] doi:10.1097/01.MIB.0000437498.14804.50 CrossrefMedlineGoogle Scholar5. Nguyen GC, Bayless TM, Powe NR, Laveist TA, Brant SR. Race and health insurance are predictors of hospitalized Crohn's disease patients undergoing bowel resection. Inflamm Bowel Dis. 2007;13:1408-16. [PMID: 17567876] CrossrefMedlineGoogle Scholar6. Amiot A, Peyrin-Biroulet L. Current, new and future biological agents on the horizon for the treatment of inflammatory bowel diseases. Therap Adv Gastroenterol. 2015;8:66-82. [PMID: 25729432] doi:10.1177/1756283X14558193 CrossrefMedlineGoogle Scholar7. Roberts SE, Williams JG, Yeates D, Goldacre MJ. Mortality in patients with and without colectomy admitted to hospital for ulcerative colitis and Crohn's disease: record linkage studies. BMJ. 2007;335:1033. [PMID: 17977817] CrossrefMedlineGoogle Scholar8. Hindryckx P, Baert F, Hart A, Magro F, Armuzzi A, Peyrin-Biroulet L; Clinical Trial Committee Clincom of the European Crohn's and Colitis Organisation (ECCO). Clinical trials in ulcerative colitis: a historical perspective. J Crohns Colitis. 2015. [PMID: 25913641] CrossrefMedlineGoogle Scholar9. Sachar DB. Clinical and colonoscopic surveillance in ulcerative colitis: are we saving colons or saving lives? [Editorial]. Gastroenterology. 1993;105:588-97. [PMID: 8335212] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From The Mount Sinai Medical Center, New York, New York.Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-1190.Corresponding Author: David B. Sachar, MD, The Mount Sinai Medical Center, Annenberg Building, Box 1069, 1 Gustave L. Levy Place, New York, NY 10029; e-mail, david.[email protected]org.This article was published online first at www.annals.org on 14 July 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMortality Associated With Medical Therapy Versus Elective Colectomy in Ulcerative Colitis Meenakshi Bewtra , Craig W. Newcomb , Qufei Wu , Lang Chen , Fenglong Xie , Jason A. Roy , Cary B. Aarons , Mark T. Osterman , Kimberly A. Forde , Jeffrey R. Curtis , and James D. Lewis Mortality Associated With Medical Therapy Versus Elective Colectomy in Ulcerative Colitis Meenakshi Bewtra , Craig W. Newcomb , Qufei Wu , Lang Chen , Fenglong Xie , Jason A. Roy , Cary B. Aarons , Mark T. Osterman , Kimberly A. Forde , Jeffrey R. Curtis , and James D. Lewis Metrics Cited byMiR-125-5p/IL-6R axis regulates macrophage inflammatory response and intestinal epithelial cell apoptosis in ulcerative colitis through JAK1/STAT3 and NF-κB pathwayTreatment and outcome of ulcerative colitis during the first 10 years after diagnosis in a prospectively followed population-based cohortElective colectomy for severe ulcerative colitis may reduce mortality more than medical therapy 18 August 2015Volume 163, Issue 4Page: 316-317KeywordsColectomyColonDrugsMedicareObservational studiesQuality of lifeStatistical methodsSurgerySurvival analysisUlcerative colitis ePublished: 18 August 2015 Issue Published: 18 August 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...