Complications de la rectocolite hémorragique et impact des traitements actuels sur l'histoire naturelle de ces complications

Ulcerative colitis is a chronic disease progressing to many complications. Impaired quality of life, both physically, professionally and emotionally, is present in the majority of cases. It is linked either to the inflammatory activity of the disease or to the alteration of colonic function due to tissue damage or to the consequences of coloproctectomy. Hospitalization rates are three times higher than the general population and motivated by extensive complications of the disease or investigations and treatments. The long-term consequences of histological inflammation are associated with a twofold risk of colorectal cancer. The surgery rate is 4.9%, 11.6%, 15.6% at 1, 5 and 10 years. The need for surgery is increased in the first years of the diagnosis in case of extensive colitis and if the disease was discovered at a young age. A reduction of inflammatory activity of UC by current treatments, including anti-TNF, leads to improved quality of life and a reduction in hospitalization rates. A reduction in the incidence of colorectal cancer in 5ASA has been demonstrated and, more recently, by purines through their anti-inflammatory activity. We do not currently have data on the effect of anti-TNF. The impact of treatment on surgery rates is controversial from one study to another and must be confirmed.