Development of an ICD Coding Definition for Inflammatory Bowel ...

Without treatment, half of the quiescent cases of CD will experience a relapse in a period
of two years. Sixty percent of the patients undergo surgery within 10 years of diagnosis,
of which, half of them will experience a clinical relapse within 4 years of surgery.
Eventually, 45% of CD patients will require another operation [6]. CD patients suffer a
plethora of disabilities in their social life such as career change, job absence, and
decreased work hours [7].
2.1.2 Ulcerative colitis
Similar to CD, ulcerative colitis is a chronic inflammatory condition of digestive tract.
UC habitually involves the rectal mucosa; however it can extend to involve the left colon
or the entire colon, a condition called —pancolitis“. UC can appear at any age but
classically happens in early adulthood. The disease is slightly more common in women
and 15% of patients have a family history of IBD [3].
The majority of the patients have proctitis or proctosigmoiditis; therefore, blood in the
stool is often the first manifestation of the disease. Apart from tenesmus and cramping,
most patients have frequent bowel movements containing pus, mucus, and blood. As
more of the colon becomes involved, diarrhea happens to be the prominent feature of the
disease.
As with CD, UC patients may develop extraintestinal complications such as skin
eruptions, arthritis and eye problems. The most important hepatobiliary complication of
UC is sclerosing cholangitis, which is characterized by inflammation, destruction and
fibrosis of the intrahepatic and extrahepatic bile ducts. Mild diffuse fatty liver changes
4