P124 The bottom line on ulcerative proctitis: an 11-year analysis of patient outcomes from a UK teaching hospital
Bibliographic record
Abstract
<h3>Introduction</h3> Ulcerative proctitis (UP), is a localized manifestation of ulcerative colitis (UC) confined to the rectum.<sup>1</sup> Between 25–55% of patients diagnosed with UC initially present with UP.<sup>2</sup>Patients with UP exhibit more favourable prognoses compared to those with extensive UC though up to 30% of those with UP progress to more extensive colitis over time.<sup>3</sup> This retrospective analysis explores the clinical trajectories of patients with UP referred to a UK teaching hospital over 11 years. <h3>Methods</h3> This study retrospectively identified patients diagnosed with UP between 2012 and 2023 at a medium-sized UK teaching hospital. Patient data, extracted from electronic health records, were analysed using descriptive statistics. <h3>Results</h3> We identified 176 patients with UP (56% male), with a median diagnostic age of 56.5 years (IQR, 43–76). The median follow-up period was 3.5 years (IQR, 1–7). At diagnosis, 13.4% (n=23) were active smokers. Endoscopic severity was classified as mild in 67 cases (62.6%) and moderate to severe in 60 (56%) of the 107 patients with available data. As initial management, 41 patients (23.2%) received topical 5-ASA, 85 (48.3%) received oral 5-ASA, 10 (5.6%) received topical steroids, and 27 (15.3%) no treatment. Treatment escalation was required for 30 patients (17.0%), with a median time from diagnosis to escalation of 12 months (IQR, 12–24). 23 patients (13.1%) had azathioprine, and 18 (10.2%) required biologics, with 4 (2.2%) needing second-line biologics. The specific biologics used were infliximab (n=7), vedolizumab (n=6), adalimumab (n=2), golimumab (n=2), and ustekinumab (n=1). Four patients (2.2%) underwent surgical resection. A total of 71 patients (40%) were discharged back to primary care after a median follow-up of 18.5 months (IQR, 8–48), and 3 (1.7%) were referred back to secondary care. <h3>Conclusion</h3> UP predominantly exhibits a mild clinical course, with a significant proportion of patients responding adequately to first-line therapy. Our findings suggest that patients with stable UP, adequately managed on 5-ASA, could be discharged to primary care after 12–18 months’ follow-up. Future research should focus on identifying predictors of 5-ASA failure in UP. <h3>References</h3> Satsangi J, Silverberg MS, Vermeire S, <i>et al.</i> The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. <i>Gut</i> 2006;<b>55</b>:749–753. Meucci G, Vecchi M, Astegiano M, <i>et al.</i> The natural history of ulcerative proctitis: a multicenter, retrospective study. <i>Am J Gastroenterol</i> 2000;<b>95</b>:469–473. Kim B, Park SJ, Hong SP, <i>et al.</i> Proximal disease extension and related predicting factors in ulcerative proctitis. <i>Scand J Gastroenterol</i>. 2014 Feb;<b>49</b>(2):177–83.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".