Natural History of Ulcerative Colitis: Current Knowledge

The clinical presentation at the time of diagnosis and the disease course of ulcerative colitis (UC) are heterogeneous and variable over time. In population-based epidemiological follow-up studies from the last decades, the extent of UC has shown only slight variation. At diagnosis, the initial extent is evenly distributed among proctitis, leftsided, and extensive colitis with some exceptions. The disease course may vary from a single attack to chronic symptoms that reduce the quality of life as well as lead to disease extension, colectomy or even to the development of colitisassociated colorectal cancer in some cases. Important predictive clinical factors and biomarkers of disease course have been under increasing scrutiny. Those identified may eventually lead to a more personalized, tailored therapy. In this review article, the authors summarize the available evidence on the natural history and predictive markers for evaluating the course of UC.