CLINICAL EPIDEMIOLOGY OF INFLAMMATORY BOWEL-DISEASE

Publications involving the clinical epidemiology of inflammatory bowel disease were plentiful in 1993. Greater understanding was made in the diagnosis, etiology, and natural history of disease. Specifically, a newer diagnostic technique of technetium-labeled leukocyte scanning appeared to be as accurate with lower radiation exposure than other nuclear medicine alternatives. Etiologically, work continued on two fronts. Genetic studies demonstrated homogenous groups within these heterogenous diseases, groups that may share etiologic, prognostic, and therapeutic advantages. Also, promising work continued the search for the infectious agents responsible for inflammatory bowel disease. Prognosis in patients with ulcerative colitis appears to be directly related to extent of disease at diagnosis. Inroads were made in finding some of the genetic mutations responsible for neoplastic transformation and cancer-related motility reduction through either risk factor intervention or surveillance of high-risk patients remained an area of considerable interest. Despite these insights, this year's literature seemed to uncover more questions than were answered.