Rectal biopsy as a prognostic guide in Crohn's colitis

Abstract

In a retrospective study, 64 rectal biopsies from 27 patients with Crohn's disease limited to the large bowel were reviewed using a semiquantitative histologic grading. The subsequent clinical course was assessed independently, and patients were included in one of 4 categories: remaining asymptomatic; showing continued moderate inflammatory activity; requiring colectomy; and dying as a direct result of colonic disease. Biopsies from the last group showed a greater degree of histologic changes than those of the other 3 groups. This difference was statistically significant for first rectal biopsies [(4)-(1) P < 0.05; (4)-(2) P < 0.05]. In any one patient the histologic appearances were relatively constant from one biopsy to the next. The presence of either fissuring or ulceration suggested a poor prognosis.