Grouping ulcerative colitis with Crohn's disease (Inflammatory
Bowel Disease) in a teaching seminar has historical support. The
medical literature includes descriptions of both diseases in the
latter half of the 19th century; they share many symptoms; in some
instances, differentiating them may be very difficult; and the
cause of each remains unknown. Furthermore, one member of a family
may suffer with Crohn's disease while another has ulcerative
colitis. And both processes are prone to the late complications of
carcinoma at a site of previous involvement. Finally, the
investigators and students of one disease have usually also
contributed to the understanding of the other disease. The
incidence of Crohn's disease seems to be increasing rapidly. This
has been sug gested by reports from Sweden, the Netherlands,
England, Scotland, and South Africa as well as the United States.
Though methods of recording data vary, the increase is further
supported by cases of greater virulence, still younger ages of
onset, and more cases in the elderly. This is remarkable when we
consider that fifty years ago, when the classic description from
Mt. Sinai Hospital was being prepared, the disease was rare. Since
the cause remains elusive, we must try to cope with this entity as
skillfully as we can, with consideration of indications, and timing
of drug and surgical intervention. The choice of forms of
management has been controversial, even among the most experi enced
physicians."
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