Xu et al reported risk factors for colorectal strictures and high-grade dysplasia in a patient with ulcerative colitis. These can help to identify a patient who may require more aggressive management. The authors are from Xinhua Hospital, Shanghai Jiao Tong University and Rui Jun Hospital in Shanghai.
Patient selection: ulcerative colitis
Risk factors for stricture formation:
(1) disease duration > 5 years (odds ratio 3.2)
(2) moderate anemia (odds ratio 3.4)
(3) primary sclerosing cholangitis (odds ratio 5.8)
Stricture is associated with:
(1) a lower rate of remission or cure
(2) the need for surgery
(3) the risk of complications
(4) malignant transformation
Risk factors for high-grade dysplasia or cancer:
(1) stricture formation (odds ratio 9.4)
(2) inflammatory polyps (odds ratio 5.5)
(3) disease duration >= 10 years (odds ratio 3.2)
(4) age >= 40 years of age at diagnosis of ulcerative colitis (odds ratio 8.5)
