Chronic Ulcerative Colitis in Childhood

Although chronic ulcerative colitis may well have been known to Sydenham (1848), it was only comparatively recently that Helmholz (1923) first recorded the occurrence of the condition in children with an account of five cases. Since that time the disease has become increasingly recognized as a condition of childhood and larger series have been reported from America (Jackman, Bargen and Helmholz, 1940; Bargen and Kennedy, 1955; Holowach and Thurston, 1956; Meeker and Goff, 1956), from Australia (Covernton, 1949), from Sweden (Lagercrantz, 1955), and more recently from England (Schlesinger and Platt, 1958). Jackman et al. (1940) found, as a result of follow-up studies, that over half of their 95 children had either become worse or had died, whereas a more recent investigation concerning 126 children (Bargen and Kennedy, 1955) revealed a much more optimistic prognosis. Between July 1, 1947, and June 30, 1956, a total of 391 patients attended the University Hospital with chronic ulcerative colitis. Of these 52 (13 3%) were aged 15 years or less when the disease first appeared. In an attempt to assess the prognosis of the condition as seen in childhood at this large medical centre, a follow-up study was initiated, the results of which form the basis for this communication. The medical records of the 52 patients were studied and cases were included only if the clinical story of chronic diarrhoea was supported by negative bacteriological findings and positive radiological or sigmoidoscopic evidence. Six of the patients had been seen as out-patients but the remainder had all been investigated or treated in hospital. Simple questionnaires were then prepared and despatched and satisfactory information was