Therapeutical experiments in ulcerative colitis and Crohn's disease.

In the period 1963-82 among the patients with aspecific inflammatory bowel disease, the incidence of ulcerative colitis was 3.1 per 100 000 per year, while the frequency of Crohn's disease has doubled during the observation period and now its incidence is 0.58 per 100 000 per year. During the past 20 years, 404 patients with ulcerative colitis were treated. The average follow-up of the patients lasted for 6.6 years. During this period, 40% of the patients could be kept in balance permanently with salicylazosulfapyridine (SASP) monotherapy. A further 34% reacted to SASP plus steroid. The rate of regression was increased by a further 14% when the combination was occasionally completed with a short-term antibiotic or prolonged azathioprine therapy. The inestimable cases and those refractory to treatment made up the other 12% and among them are also the 23 colectomized patients. During the two decades 40 patients with Crohn type ileocolitis were treated. SASP administration by itself was sufficient in only one case among them. In 6 cases steroid, in 4 antibiotics, in 7 azathioprine and in 2 cases metronidazole treatment had to be introduced complementarily. The fact that 21 of the 40 patients had to be subjected to bowel resection in some phase of the disease, shows how impossible it is to evaluate the different therapeutic interventions.