Relationships between drug regime and histology of rectal mucosa in Crohn's disease.

In the scope of the ECCDS, testing the efficacy of prednisolone and/or sulfasalazine in Crohn's disease, the relationships between drug regime and histology of rectal mucosa were studied. Rectal biopsies, gained at start and after termination of treatment were available in 57 patients. Additionally, biopsies of 20 normal controls were studied. The biopsies, cut completely in serial sections, were investigated by quantitative histological methods. The data were evaluated by multivariate discriminant analyses. The nearest approach of histologic pattern to normal was found after combined treatment with prednisolone and sulfasalazine, followed by prednisolone monotherapy. The effect of sulfasalazine as monotherapy was poor. The degree of normalisation in histologic pattern agrees very well with the CDAI in our subsets. Overall, effective therapy was reflected in histology of rectal mucosa by a decrease of acute inflammatory alterations and an increase of mononuclear infiltration. Only minor individual effects of the various drug regimes were found.