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Twenty-two patients with chronic proctitis were treated with metronidazole for 28 days in a double-blind controlled trial, but they did not appear to benefit from the drug.
Follow-up studies of 2 groups of patients with idiopathic proctitis show that the survival rate is little affected by the disease. The cumulative probability of extension of the inflammation to the descending colon above the left iliac crest was about 5% at 5 years and 12% at 10 years. Corresponding figures for extension to the hepatic flexure were about 4% at 5 years and 6% at 10 years. The probability of radical surgical treatment was 3--5%.
Oral razoxane 125 mg daily brought active Crohn's disease into remission when used alone and mainly on an out-patient basis in all nine patients studied. Remissions took several months to achieve, but no relapses have occurred on treatment and no surgery has been necessary in any of the patients. In the two patients with active non-specific proctitis, oral razoxane 125 mg daily rapidly controlled the condition. Apart from mild bone marrow toxicity in one patient, no other acute toxicity has occurred and no long-term side-effects have been observed.
A group of 1,533 homosexual males were examined in 1976 for gonorrhea at the Skin Clinic of the Boston Dispensary. This examination included a rectal culture. There were 213 males with positive rectal cultures: an infection rate of 13.7%. Of these, 173 were treated with 4 g of spectinomycin hydrochloride, intramuscularly, and 127 (73.4%) returned in one week for a posttreatment examination and culture. All who returned had a negative culture. Four grams of intramuscular spectinomycin hydrochloride appears to be effective in the treatment of gonococcal proctitis.
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269 patients with ulcerative colitis and a history of less than 6 months when first seen at St. Mark's Hospital in the decade 1966--75 have been followed for up to 11 years. The outcome has been correlated with the maximum extent of the disease observed within 3 months of presentation. 75 patients required hospital admission, 56 within a year of presentation. Extensive colitis developed in 60 patients. The cumulative probability of the disease being extensive was 21% +/- 3% at 5 years and 29% +/- 4% at 10 years. 25 patients required surgical treatment. The cumulative probability of operation was 8% +/- 2% at 5 years and 15% +/- 4% at 10 years. 19 patients are known to have died. The expected number of deaths was 19.2.
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