Læknablaðið

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Læknablaðið - 15.09.1982, Page 14

Læknablaðið - 15.09.1982, Page 14
202 LÆKNABLAÐID hjá körlum. Erfitt er að benda á ástæðu fyrir þessari aukningu, enda orsök sjúkómsins ókunn. Hjá okkur vistuðust um 75 % sjúklinganna einhvern tíma á sjúkrahúsi vegna sjúkdómsins, en 25 % lögðust aldrei inn. Tölur frá Englandi áætla að aðeins um helmingur sjúklinga með sjúkdóminn leggist inn (10). Nokkrar rannsóknir sýna hærra nýgengi hjá borgarbúum en sveitafólki (11). Á tímabilinu 1950 til 1974 voru 56 % sjúklinganna búsettir í Reykjavík og Kópavogi við greiningu, en aðeins 16% í sveitum, en 1975 til 1979 voru 45 % búsettir í Reykjavík og Kópavogi en aðeins 11 % í sveitum. Árið 1950 bjuggu 27 % íslendinga í sveitum, en á miðju tímabilinu, 1964, aðeins 18%, og árið 1969 hafði sveita- fólki fækkað í 15%. Árið 1964 bjuggu 41 % landsmanna í Reykjavík og árið 1969 um 40 %. Nýgengi sjúkdómsins hér á landi virðist ívið hærra meðal borgar- og bæjarbúa en sveitafóks. Höfundar vilja pakka Pórði Harðasyni, yfirlækni, fyrir góðar ábendingar og Gerði Helgadóttur, læknaritara. fyrir vélritun. SUMMARY This study describes the incidence and prevalence of ulcerative colitis in Iceland during a 30 year period, 1950 to 1979. Diagnosis of new patients was based on clinical signs and proctosigmoidoscopy and in addition in most cases by biopsy (82 %) and X-ray of the large bowel. Total of 316 patients were diagnosed, 175 men, 55.4 %, and 141 women, 44.6 %. The male-female ratio for the total period was 1.24, but changed from 0.6 the first decade to 1.5 the last decade. The most frequent age was 31 to 40 years and the second frequent 21 to 30 years in both men and women. The disease was classified into four stages according to distribution of the disease at diagnosis, proctitis, proctosigmoiditis, distal colitis and total colitis. The most frequent stage of distribution was proctosigmoiditis and the second most frequent proctitis but least frequent total colitis. There were more men in all stages except total colitis, where there were more women. The average annual incidence of the disease was 2.8 the first decade, 1950 to 1959, 4.7 the second decade, 1960 to 1969, and 7.4 per 100.000 the last decade, 1970 to 1979. The average annual incidence of proctitis during the same period was o.6 the first decade, 1.4 the second decade, and 2.7 per 100.000 the last decade. The prevalence in the end of the year 1950 was 8.4 but increased to 122.2 per 100.000 in the end of the year 1979. The study indicates, that there has been a steady and definite increase in the diagnosis of the disease during the whole study period, especially the last five years. This increase can mostly, but not wholly, be accounted for by more frequent diagnosis of less extensive disease, proctitis and proctosigmoiditis, especially amongst men. HEIMILDIR 1. Björnsson S, Þorgeirsson Þ, Guðnasson Þ. Mor- bus Crohn á íslandi 1950-1979. Faraldsfræðileg könnun á 30 ára tímabili. Læknablaðið 1981; 67: 238-244. 2. Sinclair TS, Brunt PW, Mowat NAG. Natural history of proctocolitis in the North-East of Scotland: A community study. Gut 1980; 21 (10); A-924. 3. Evans JG, Acheson ED. An epidemiological study of ulcerative colitis and regional enteritis in the Oxford area. Gut 1965;6:311-324. 4 Myren J, Gjone R, Hertzberg JN, Rygvold O, Semb LS, Fretheim B. Epidemiology of ulcerati- ve colitis and regional enterocolitis (Crohns- disease) in Norway. Scand J Gastroent 1971; 6: 511-514. 5. Bonnevie O, Riis P, Anthoniesen P. An epidemi- ological study of ulcerative colitis in Copenha- gen county. Scand J Gastroent 1968; 3: 432-438. 6. Brahme F, Lindström C, Wenckert A. Crohns- disease in a defined population. Gastroenterolo- gy 1975;69:342-351. 7. Monk M, Mendeloff AJ, Siegel CI, Lilienfeld A. An epidemiological study of ulcerative and regional enteritis among adults in Baltimore. Gastroenterology 1967; 53: 198-210. 8. Gilat T, Ribak J, Benavoy J et al. Ulcerative colitis in the Jewish population of Tel Aviv-Jafo. Gastroenterology 1974; 66: 335-342. 9. Wigley RD, MacLaurin B. A study of ulcerative colitis in New Zealand showing a low incidence in Maoris. Brit Med J 1962; 2: 228-231. 10. Langman MJS. In the epidemiology of chronic digestive disease. Edward Arnold publ., 41 Bedford Square, London. Chapter 4, 80-102. 11. Mendeloff AI. The epidemiology of inflammato- ry bowel disease in Clinics in Gastroenterology 1980;3:259-270. 12. Munro A. MS Thesis Univ. of Aberdeen 1978. 13. Myers A, Humphreys DM, Cox EV. A ten year follow-up of haemorrhagic proctitis. Postgrad Med J 1976;52;224-228. 14. Lennard-Jones JE, Cooper GW, Newell AC, Wilson CWE, Avery Jones F. Observation of an idiopathic proctitis. Gut 1962; 3: 201. 15. Powell-Tuck J, Ritchie JK, Lennard-Jones JE. The prognosis of idiopathic proctitis. Scand J Gastroent 1977; 12: 727-732. 16. Ritchie JK, Powell-Tuck J, Lennard-Jones JE. Clinical outcome of the first ten years of ulcerative colitis and proctitis. Lancet 1978; i: 1140-1143.

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