Highlights From Section 2: Classification
ECCO statement 2A
Disease extent influences treatment modality, whether oral and/or topical therapy [EL1], and determines onset and frequency of surveillance [EL2]. It is defined by the maximal macroscopic extent at colonoscopy, classified as proctitis, left-sided colitis, and extensive colitis
ECCO statement 2B
Disease severity influences treatment modality and route of administration [EL1]. Clinical indices of disease severity have not been adequately validated, although clinical, laboratory, imaging, and endoscopic parameters, including histopathology, impact on patients’ management [EL 2]. Remission is defined as stool frequency ≤ 3/day, no rectal bleeding, and normal mucosa at endoscopy [EL5]. Absence of a histological acute inflammatory infiltrate predicts quiescent course of disease [EL3]
ECCO statement 2C
A classification of ulcerative colitis according to age at onset is of value [EL2], as early-onset disease has a less favourable course. Classification according to the concomitant presence of primary sclerosing cholangitis* is important as it increases the need for and frequency of surveillance colonoscopy [EL2]
* See Primary Sclerosing Cholangitis: Therapeutic Options and Surveillance Management [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Clin Med Insights Gastroenterol. 2016 Jun 9;9:25-9. doi: 10.4137/CGast.S38451. eCollection 2016.
* See also Primary Sclerosing Cholangitis Updated: Nov 20, 2016 from Emedicine/Medscape
ECCO statement 2D
The routine clinical use of genetic or serological molecular markers is not recommended for the classification of ulcerative colitis [EL2]
